Frankiewicz Mikołaj, Połom Wojciech, Matuszewski Marcin
Department of Urology Medical University of Gdańsk, Gdańsk, Poland.
Cent European J Urol. 2018;71(1):108-113. doi: 10.5173/ceju.2017.1450. Epub 2017 Dec 29.
Great advances in medical research concerning methods of contraception have been achieved in recent years, however, more than 25% of couples worldwide still rely on condoms - a method with poor efficacy. Even though there is a spectrum of 11 different contraceptive methods for women, there are only 4 commonly used by men (condoms, periodic abstinence, withdrawal and vasectomy). In this review, advances and present, state-of-the-art, both hormonal and non-hormonal male contraceptive methods will be presented and evaluated. Potential novel targets that warrant greater research will be highlighted.
A comprehensive literature search without a time limit was performed using the Medline database on May 2017. The terms 'male contraception' in conjunction with 'reversible inhibition of sperm under guidance' (RISUG), 'hormonal', 'non-hormonal', 'vasectomy' or 'testosterone' were used. The articles were limited to those published in English, Polish or French.
There are various contraceptives currently available to regulate male fertility. Vasectomy is still the most effective permanent form of male contraceptive with a failure rate lower than 1%. Reversible, non hormonal methods of male contraception, like reversible inhibition of sperm under guidance, are very promising and close to being introduced into the market. In regards to hormonal contraception research, the use of testosterone injections has been widely studied yet they often harbor undesirable side effects and require further development.
Despite continuous efforts worldwide, it seems that another several years of research is needed to provide safe, effective and affordable male contraceptives which will allow both men and women to participate fully in family planning.
近年来,医学研究在避孕方法方面取得了巨大进展,然而,全球仍有超过25%的夫妇依赖避孕套——一种效果不佳的方法。尽管有11种不同的女性避孕方法,但男性常用的只有4种(避孕套、周期性禁欲、体外射精和输精管切除术)。在本综述中,将介绍和评估激素和非激素男性避孕方法的进展及当前的先进技术。将突出值得进一步研究的潜在新靶点。
2017年5月使用Medline数据库进行了无时间限制的全面文献检索。使用了“男性避孕”与“在引导下可逆抑制精子”(RISUG)、“激素”、“非激素”、“输精管切除术”或“睾酮”相结合的术语。文章仅限于以英语、波兰语或法语发表的。
目前有多种避孕药可用于调节男性生育能力。输精管切除术仍然是最有效的永久性男性避孕方式,失败率低于1%。可逆的非激素男性避孕方法,如在引导下可逆抑制精子,非常有前景,且已接近推向市场。关于激素避孕研究,睾酮注射的应用已得到广泛研究,但它们往往存在不良副作用,需要进一步改进。
尽管全球一直在不断努力,但似乎还需要数年的研究才能提供安全、有效且价格合理的男性避孕药,使男性和女性都能充分参与计划生育。