Wu F C
Department of Medicine, University of Manchester, U.K.
Baillieres Clin Obstet Gynaecol. 1996 Apr;10(1):1-23. doi: 10.1016/s0950-3552(96)80059-9.
With the powerful tools of molecular investigation, the last decade has witnessed the most remarkable scientific advance in our history, yet no new leads for male contraception have been forthcoming. All the likely methods of male contraception discussed above were derived from relatively 'old' physiological principles or serendipitous observations. The increasing gap between fundamental research (in the control of mammalian spermatogenesis) and the lack of clinical application are a testament to the low public funding priority afforded to male reproduction and the unwillingness of the pharmaceutical industry to invest in male reproductive research and development. Yet amidst such an unfavourable setting and with very limited support, it is heartening to note that the prospects of introducing a new systemic method for male contraception into the market by the end of this millenium has been greatly enhanced. Thus the results of recent studies have confirmed the contraceptive efficacy of sex steroid-induced oligozoospermia and unexpectedly revealed an ethnically distinct pattern of susceptibility to the hormonal suppression of spermatogenesis. Thus, Asian men are more responsive than are caucasian, and long-acting testosterone esters now being tested in that most densely populated part of the world may well hasten the large-scale application of this method. This is probably the most effective way to correct the misconceptions that men are unwilling or disinterested in sharing in family planning options with their partners. Together with the increased acceptance of novel non-surgical and reversible methods of vas deferens occlusion and the availability of improved non-latex condoms, the currently unfulfilled contraceptive needs of millions of men can be increasingly met in future years. The consequent increase in overall contraceptive prevalence could well make the telling difference between demographic catastrophe and maintaining good quality existence. Politicians, scientists and industrialists need to wake up to their responsibilities and the opportunities offered by this untapped resource and market potential.
借助强大的分子研究工具，过去十年见证了我们历史上最显著的科学进步，但男性避孕方面却没有新的线索出现。上述所有可能的男性避孕方法均源自相对“古老”的生理学原理或偶然观察。基础研究（关于哺乳动物精子发生的控制）与临床应用缺失之间的差距日益增大，这证明了男性生殖领域获得的公共资金优先级较低，也表明制药行业不愿投资于男性生殖研究与开发。然而，在如此不利的环境下且支持非常有限的情况下，令人欣慰的是，到本世纪末将一种新的全身性男性避孕方法推向市场的前景已大为改善。因此，近期研究结果证实了性类固醇诱导的少精子症的避孕效果，并且意外地揭示了在精子发生激素抑制方面存在种族差异的易感性模式。因此，亚洲男性比白种男性更敏感，目前正在世界人口最密集地区进行测试的长效睾酮酯很可能会加速这种方法的大规模应用。这可能是纠正男性不愿意或不关心与伴侣共同参与计划生育选择这种误解的最有效方式。随着新型非手术和可逆性输精管阻塞方法的接受度提高以及改进的非乳胶避孕套的出现，未来几年数百万男性目前未得到满足的避孕需求将越来越多地得到满足。随之而来的总体避孕普及率的提高很可能会在人口灾难与维持高质量生活之间产生显著差异。政治家、科学家和实业家需要意识到自己的责任以及这一未开发资源和市场潜力所带来的机遇。
