Tuesday, May 08, 2007

An IUD For The Boys

Ob.Gyn.News has a quick review of promising male birth control methods. Check out #3, the IVD (Intra Vas Device):

1. Reversible inhibition of sperm under guidance (RISUG). This method of male contraception involves vas deferens injections of styrene maleic anhydride in the solvent dimethyl sulfoxide.

2. Adjudin (also called AF-2364). This is an analogue of an old anticancer drug called lonidamine that is conjugated to follicle-stimulating hormone (FSH).

3. The Intra Vas Device (IVD). This device is composed of a set of two flexible silicon plugs, 1 inch long and either 1.2 mm or 1.4 mm in diameter. The plugs are inserted in the vas deferens, separated by a small space, and they physically block the passage of sperm. After they have been inserted, the patient can neither feel nor palpate the device.

The no-scalpel procedure can be performed by anyone experienced in vasectomy. It is expected to cost about $1,000, which is comparable to a vasectomy. Unlike a vasectomy, however, reversal would theoretically be much simpler and much less expensive—about another $1,000, compared with $5,000-$12,000 for a vasovasostomy.

In May 2006, the Food and Drug Administation (sic) approved human trials with this device, and if all goes according to plan, approval is expected in Europe, Canada, and the United States by 2010.

4. Suppression of spermatogenesis with transdermal testosterone gels plus various progestins.

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At 4:17 PM, Blogger Erin said...

Sounds good but when we can't convince men to shell out $10 for condoms, how're we gonna get em to shell out a grand?

At 6:37 AM, Blogger figleaf said...

If I can respond to Erin's question I think it's a good one but sort of missing the point.

As we get closer to realizing contraceptive alternatives for men that go beyond condoms (still not reliable enough for *me* to ever trust) and vasectomies (safe, reliable, but $5,000-$12,000 to reverse -- mine cost around $7,000) you're likely to see men applying a little more peer pressure to each other to conform. Based on my own experience back... contraceptive options for men were exactly as limited as they are now... the tendency was for us just to throw up our hands and hope our partners could go on the pill or get an IUD. Men aren't dumb, nor as selfish as we might seem, but if we have options we're more likely to check them out. If we have *multiple* reliable, non-permanent options we're even likely to go all gear-head about it and argue with each other about which method is the most excellent.

I was talking about this with Heather Corrina the other day. She expressed concern that guys wouldn't go for male contraceptives unless they promised some sort of energy boost or something to go along with them. I mentioned research on testosterone-based contraceptives (which Ema references in this post) and, while I don't think it does what most guys think it does, a savvy marketer probably might just point to the name and not mention that it probably wouldn't make them grow antlers.

Finally, Heather also mentioned that she wasn't sure she'd trust men, especially young men, to tell the truth about whether they were really using non-device contraceptives. My first response was that none of my partners ever questioned that I had a vasectomy at age 21. My second response, though, since I was as surprised as she, is that it shouldn't be *that* difficult to develop an inexpensive antibody-based test strip similar to pregnancy test strips that could indicate either the presence of contraceptives or the absence of sperm in the man's bodily fluids. (Preferably oral fluids, less optimally "pre-come.") A lot of bars already have coin-operated breathalyzers, and far more have mult-product condom dispensers. It just doesn't seem like that much of a stretch to look for test kits the woman could buy and ask the man to use.

I don't *think* I'm talking through my hat about any of this.

By the way, Ema, thanks for posting this list. If you know of any clearinghouses or foundations dedicated to male contraception I'd love to know about it. I'd donate money myself and encourage my readers and anyone else to donate as well. I think it's a serious problem that there have been no real new developments in this area since before I was born... in the 1950s!


At 2:11 AM, Blogger Callisto said...

Figleaf, you have heaps of great comments there, and I just wanted to point out that as to believing whether your partner truly is sterile or not, I always favoured the "two or more forms of contraceptive" approach. I think every person should be responsible for their procreation rights, and so I firmly believe BOTH partners should be using contraceptive.

But a handy little test strip thing like you're talking about would be handy too *grin*.


At 3:46 AM, Blogger cynicalgrad said...

Also check out Nelly Oudshoorn's fabulous book The Male Pill which addresses the 30+ YEARS of the various processes that have impeded the development of male contraception. She also deals very well with the ways in which male resistances to contraception has been shaped over the years, including the ways in which the women's health movement's emphasis on our bodies ourselves has contributed to this (not anti-women's health movement, just an interesting point about how women's fight to control our bodies has had an effect in unexpected ways).

At 9:52 AM, Blogger Candice said...

If women are going to have to buy test strips to test the men they want to sleep with, then doesn't that shift the reproductive responsibility back onto the woman. I also believe that female and male birth control should be used, as Calli mentioned. Personal responsibility first. However, the strips aren't a bad idea--they'd just need to be available to both men and women. I don't buy this men are untrustworthy and women are inherently trustworthy. It needs to go both ways. Hallelujah for male birth control!

At 8:09 PM, Blogger North said...

I don't really get having trust issues about your partner actually using birth control. My personal take is that if I'm sleeping with someone I don't totally trust, we're using condoms anyway because I don't trust said person to tell me his or her HIV/STD status any more than I trust him to tell me his fertility status. For me, any kind of non-barrier method is only an option once we fully trust each other, at which point I'm not worried that he's lying when he tells me he got plugs put in.

At $1000, these things are going to be at least twice as expensive as the IUD, though that cost will probably come down over time. Any bets on whether insurers will cover it?

At 5:23 AM, Anonymous US RISUG said...

Great idea with having a test to 'prove' a man is using something such as RISUG where there is nothing to remember to take each day. There are in fact test kits available for a mans sperm, they don't work for that same night, but for a dating relationship or marriage it would be perfect.

I see men very willing to spend $1000 for birth control, in fact I think they will spend more than that, just look at the vesectami market! If RISUG can deliver 10 years of child free sex, there will be men lining up for it.


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