Anderson R A, Reynolds-Wright J J
Centre for Reproductive Health, Institute of Regeneration and Repair, University of Edinburgh, UK.
Centre for Reproductive Health, Institute of Regeneration and Repair, University of Edinburgh, UK.
Best Pract Res Clin Obstet Gynaecol. 2024 Dec;97:102559. doi: 10.1016/j.bpobgyn.2024.102559. Epub 2024 Sep 24.
The concept of a hormonal approach that sufficiently and reversibly suppresses spermatogenesis to the level required for effective contraception has been developed and tested over several decades. The reality of achieving this has been confirmed using both testosterone alone and combination methods using a progestogen with a physiological dose of testosterone, necessary to replace the lack of endogenous testosterone production by the suppressed testes. A range of both long-acting and self-administered combination methods are effective, including injection, implant and gel methods of administration, with up to 95% of men achieving sufficient spermatogenic suppression. New steroids are also being trialled. Surveys show the widespread willingness of men and their female partners to use novel male methods, suggesting the potential of this approach to contribute to global family planning and sustainable development goals. This approach to contraception can clearly be effective, and needs to move from relatively small scale testing to large scale pre-marketing trials: only then can information about long-term safety and real-world acceptability be obtained.
一种通过激素手段充分且可逆地将精子发生抑制到有效避孕所需水平的概念，已历经数十年的发展与测试。通过单独使用睾酮以及使用生理剂量睾酮与孕激素的联合方法（这对于弥补被抑制睾丸内源性睾酮分泌不足是必要的），已证实实现这一目标的可行性。一系列长效和自我给药的联合方法均有效，包括注射、植入和凝胶给药法，高达95%的男性实现了足够的生精抑制。新型类固醇也在进行试验。调查显示男性及其女性伴侣普遍愿意采用新型男性避孕方法，这表明该方法有助于实现全球计划生育和可持续发展目标。这种避孕方法显然是有效的，需要从相对小规模的测试转向大规模的上市前试验：只有这样才能获得有关长期安全性和实际可接受性的信息。
