Practice and development of male contraception: European Academy of Andrology and American Society of Andrology guidelines

Author:

Wang Christina1,Meriggiola Maria Cristina2,Amory John K.3,Barratt Christopher L. R.4ORCID,Behre Hermann M.5,Bremner William J.3,Ferlin Alberto6ORCID,Honig Stanton7,Kopa Zsolt8ORCID,Lo Kirk9,Nieschlag Eberhard10ORCID,Page Stephanie T.11,Sandlow Jay12,Sitruk‐Ware Regine13,Swerdloff Ronald S.14ORCID,Wu Frederick C. W.15,Goulis Dimitrios G.16

Affiliation:

1. Division of Endocrinology, Department of Medicine and Clinical and Translational Science Institute The Lundquist Insitute and Harbor‐UCLA Medical Center Torrance California USA

2. Division of Gynecology and Human Reproduction Physiopathology IRCCS Azienda Ospedaliero‐Universitaria di Bologna Bologna Italy

3. Department of Medicine University of Washington School of Medicine Seattle Washington USA

4. Division of Systems and Cellular Medicine Medical School Ninewells Hospital University of Dundee Dundee Scotland

5. Center for Reproductive Medicine and Andrology University Medicine Halle Halle Germany

6. Unit of Andrology and Reproductive Medicine Department of Medicine University of Padova Padova Italy

7. Division of Reproductive and Sexual Medicine Department of Urology Yale University School of Medicine New Haven Connecticut USA

8. Department of Urology Andrology Centre Semmelweis University Budapest Hungary

9. Division of Urology Department of Surgery University of Toronto Toronto Canada

10. Center of Reproductive Medicine and Andrology University Hospital Münster Germany

11. Division of Metabolism Endocrinology and Nutrition UW Medicine Diabetes Institute University of Washington School of Medicine Seattle Washington USA

12. Department of Urology Medical College of Wisconsin Milwaukee Wisconsin USA

13. Center for Biomedical Research Population Council New York New York USA

14. Division of Endocrinology Department of Medicine The Lundquist Institute and Harbor‐UCLA Medical Center Torrance California USA

15. Division of Endocrinology Diabetes and Gastroenterology Faculty of Biology, Medicine and Health School of Medical Sciences University of Manchester Manchester UK

16. First Department of Obstetrics and Gynecology Unit of Reproductive Endocrinology Medical School Aristotle University of Thessaloniki Thessaloniki Greece

Abstract

AbstractBackgroundsDespite a wide spectrum of contraceptive methods for women, the unintended pregnancy rate remains high (45% in the US), with 50% resulting in abortion. Currently, 20% of global contraceptive use is male‐directed, with a wide variation among countries due to limited availability and lack of efficacy. Worldwide studies indicate that >50% of men would opt to use a reversible method, and 90% of women would rely on their partner to use a contraceptive. Additional reasons for novel male contraceptive methods to be available include the increased life expectancy, sharing the reproductive risks among partners, social issues, the lack of pharma industry involvement and the lack of opinion makers advocating for male contraception.AimThe present guidelines aim to review the status regarding male contraception, the current state of the art to support the clinical practice, recommend minimal requirements for new male contraceptive development and provide and grade updated, evidence‐based recommendations from the European Society of Andrology (EAA) and the American Society of Andrology (ASA).MethodsAn expert panel of academicians appointed by the EAA and the ASA generated a consensus guideline according to the GRADE (Grading of Recommendations, Assessment, Development and Evaluation) system.ResultsSixty evidence‐based and graded recommendations were produced on couple‐centered communication, behaviors, barrier methods, semen analysis and contraceptive efficacy, physical agents, surgical methods, actions before initiating male contraception, hormonal methods, non‐hormonal methods, vaccines, and social and ethical considerations.ConclusionAs gender roles transform and gender equity is established in relationships, the male contribution to family planning must be facilitated. Efficient and safe male‐directed methods must be evaluated and introduced into clinical practice, preferably reversible, either hormonal or non‐hormonal. From a future perspective, identifying new hormonal combinations, suitable testicular targets, and emerging vas occlusion methods will produce novel molecules and products for male contraception.

Publisher

Wiley

Subject

Urology,Endocrinology,Reproductive Medicine,Endocrinology, Diabetes and Metabolism

Reference190 articles.

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2. Contraceptive failure in the United States: estimates from the 2006–2010 National Survey of Family Growth;Sundaram A;Perspect Sex Reprod Health,2017

3. Contraceptive use in the United States by method [Internet].Guttmacher Institute;2018.https://www.guttmacher.org/fact‐sheet/contraceptive‐method‐use‐united‐states

4. Use of male methods of contraception worldwide;Ross J;J Biosoc Sci,2017

5. Attitudes toward male fertility control: results of a multinational survey on four continents;Heinemann K;Hum Reprod Oxf Engl,2005

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