An “IUD” For Men
ADAM is one of the first minimally invasive, temporary solutions in human trials that men can take to prevent unwanted pregnancies. By way of contrast, those who are assigned female at birth typically bear the burden of contraception, taking hormonal contraceptives that have the potential to lead to blood clots, hormonal imbalances, stroke, and heart attacks. ADAM would instead focus on the source of sperm: those assigned male at birth. Joshua Bodie, MD, a urologic surgeon and associate professor at the University of Minnesota Medical School, points out that there are very few options for male birth control. “Right now, vasectomy is the only permanent method of male birth control. This [hydro]gel gives another option from the male side of things, other than a condom,” he says. Delivered via injection, ADAM is a hydrogel that lasts approximately two years. The procedure itself takes about thirty minutes. This is similar in range to hormonal IUDs implanted through the cervix and into the fallopian tubes, but far less invasive. IUDs carry numerous side effects, similar to those of oral contraceptives, but with the additional concern of tearing the cervix or the uterine wall. Needless to say, ADAM could change the way we think about the onus of birth control in our culture. “If [the study] is successful, [ADAM] could be a game-changer, ensuring that contraception is a shared responsibility between couples,” says Nathan Lawentschuk, a urologist at Epworth Freemasons Hospital in Australia and the study’s principal investigator.
Impact on Male Contraception
Urologists are watching this area of development with concerted interest. Since there are no approved methods for long-term male birth control in the United States, scientists and doctors have been watching as other countries try new avenues. “There already exists a similar procedure that’s being done in other countries. In China, providers have been using cyanoacrylate (essentially Super Glue) injected into the vas deferens to block the flow of sperm from the testicles. This method is NOT done in the [United States], as this is not FDA approved, nor will it likely ever be,” Dr. Bodie explains. Dr. Bodie is optimistic about ADAM, saying men prefer non-surgical options. However, results from the clinical trial will be necessary to allay all of Dr. Bodie’s concerns. Among his questions are whether there will be scarring from injection and if the hydrogel will last long enough in the vans deferens to truly be a long-term option. He also has reservations about whether the ADAM contraceptive gel will be truly reversible, and whether the product will cause a permanent biological blockage because of the build-up of dead sperm. But he says the idea of a product like ADAM is intriguing. “If there is a less painful or less invasive method than vasectomy, I think it would likely be very popular. Mainly it needs to be 100% reliable and it does need to be permanent. New technology cannot be equal to vasectomy to catch on, it would have to be better,” he says.
Other Male Contraceptives In Development
Despite the introduction of hormonal birth control, 44% of all pregnancies globally are unintended; yet 78% of men believe their partners share equal responsibility in preventing pregnancy. Male contraceptives can be broken into two categories: hormonal and non-hormonal. Male hormonal contraception reduces the production of sperm through the application of testosterone, and sometimes progestin. A pill named “The Clean Sheets Pill” acted in this manner to block the release of sperm. However, the trial was shuttered because of a lack of funding. Nexplanon, a sub-dermal implant that many assigned female at birth have taken as contraception, is under study as a male contraceptive. Men are given the implant, as well as testosterone shots every 4-6 weeks. This significantly lowered sperm count and the results lasted for up to a year. Similarly, there were studies run by the University of California, Los Angeles, The University of Sydney, and The United Nations World Health Organization analyzing the efficacy of weekly testosterone shots on decreasing sperm production. There are also non-hormonal options in development, many of them like ADAM. RISUG, a one-time injectable, is in late-stage clinical tests in India, China, and the United States, and promises to be effective for up to ten years. Vasalgel, based on RISUG, is employed in much the same way as ADAM. The final non-hormonal option for male birth control is Gendarussa, which has been used in Papua, New Guinea with 99% efficacy. This option is based on Justicia gendarussa, a native Indonesian plant. With so many options in development, birth control use might be nearing an ever-elusive place of equity across genders.
