Kamischke Axel, Nieschlag Eberhard
Institute of Reproductive Medicine of the University, Domagkstr. 11, D-48129, Muenster, Germany.
Trends Pharmacol Sci. 2004 Jan;25(1):49-57. doi: 10.1016/j.tips.2003.11.009.
The use of androgens is an essential part of all experimental approaches to hormonal male contraception and involves the suppression of gonadotrophins, leading to inhibition of spermatogenesis. Although clinical trials have proven the concept of hormonal male contraception, their modalities have been unacceptable for practical use for several reasons. Because the efficacy of all self-administered androgen preparations has been disappointing, recent studies have focused on either androgen implants or injectable, long-acting testosterone esters such as testosterone undecanoate. However, in contrast to East Asian men, only two-thirds of Caucasian men respond to such androgen-based regimens with the desired azoospermia (no sperm produced), and thus additional agents are required. Over the past decades various combinations of androgen preparations with different progestins or gonadotrophin-releasing-hormone antagonists have been tested in clinical trials. Of these, testosterone administered in combination with either depot medroxyprogesterone acetate, norethisterone enanthate, desogestrel or etonogestrel have shown promising efficacy.
雄激素的使用是所有激素男性避孕实验方法的重要组成部分，涉及抑制促性腺激素，从而抑制精子发生。尽管临床试验已经证实了激素男性避孕的概念，但由于多种原因，其方式在实际应用中并不被接受。由于所有自我给药的雄激素制剂的疗效都不尽人意，最近的研究集中在雄激素植入物或注射用长效睾酮酯，如十一酸睾酮。然而，与东亚男性不同，只有三分之二的白人男性对这种基于雄激素的方案产生预期的无精子症（不产生精子）反应，因此需要额外的药物。在过去几十年中，雄激素制剂与不同孕激素或促性腺激素释放激素拮抗剂的各种组合已在临床试验中进行了测试。其中，睾酮与醋酸甲羟孕酮长效注射剂、庚酸炔诺酮、去氧孕烯或依托孕烯联合使用已显示出有前景的疗效。
