Hum Reprod Update
Department of Biophysics and Pharmacology, Institute of Biosciences of Botucatu, São Paulo State University, Botucatu, Brazil.
Published: September 2023
Background: The high rates of unintended pregnancy and the ever-growing world population impose health, economic, social, and environmental threats to countries. Expanding contraceptive options, including male methods, are urgently needed to tackle these global challenges. Male contraception is limited to condoms and vasectomy, which are unsuitable for many couples. Thus, novel male contraceptive methods may reduce unintended pregnancies, meet the contraceptive needs of couples, and foster gender equality in carrying the contraceptive burden. In this regard, the spermatozoon emerges as a source of druggable targets for on-demand, non-hormonal male contraception based on disrupting sperm motility or fertilization.
Objective And Rationale: A better understanding of the molecules governing sperm motility can lead to innovative approaches toward safe and effective male contraceptives. This review discusses cutting-edge knowledge on sperm-specific targets for male contraception, focusing on those with crucial roles in sperm motility. We also highlight challenges and opportunities in male contraceptive drug development targeting spermatozoa.
Search Methods: We conducted a literature search in the PubMed database using the following keywords: 'spermatozoa', 'sperm motility', 'male contraception', and 'drug targets' in combination with other related terms to the field. Publications until January 2023 written in English were considered.
Outcomes: Efforts for developing non-hormonal strategies for male contraception resulted in the identification of candidates specifically expressed or enriched in spermatozoa, including enzymes (PP1γ2, GAPDHS, and sAC), ion channels (CatSper and KSper), transmembrane transporters (sNHE, SLC26A8, and ATP1A4), and surface proteins (EPPIN). These targets are usually located in the sperm flagellum. Their indispensable roles in sperm motility and male fertility were confirmed by genetic or immunological approaches using animal models and gene mutations associated with male infertility due to sperm defects in humans. Their druggability was demonstrated by the identification of drug-like small organic ligands displaying spermiostatic activity in preclinical trials.
Wider Implications: A wide range of sperm-associated proteins has arisen as key regulators of sperm motility, providing compelling druggable candidates for male contraception. Nevertheless, no pharmacological agent has reached clinical developmental stages. One reason is the slow progress in translating the preclinical and drug discovery findings into a drug-like candidate adequate for clinical development. Thus, intense collaboration among academia, private sectors, governments, and regulatory agencies will be crucial to combine expertise for the development of male contraceptives targeting sperm function by (i) improving target structural characterization and the design of highly selective ligands, (ii) conducting long-term preclinical safety, efficacy, and reversibility evaluation, and (iii) establishing rigorous guidelines and endpoints for clinical trials and regulatory evaluation, thus allowing their testing in humans.
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http://dx.doi.org/10.1093/humupd/dmad008 | DOI Listing |
J Am Board Fam Med
January 2025
From the University of Missouri, Columbia, MO (SHM, CT, LM).
Counsel patients that their Mirena IUD retains contraceptive effectiveness for extended use up to 8 years. The cumulative failure rate for years 6 through 8 was 0.68%, similar to reported rates for the first 5 years of use.
View Article and Find Full Text PDFBMJ Sex Reprod Health
January 2025
Chalmers Sexual and Reproductive Health Service, NHS Lothian, Edinburgh, UK.
Background: Pregnancy within a year of childbirth has negative impacts on women and their children's health. We developed a digital health intervention (DHI) to empower women in contraceptive choices postpartum. Our pilot randomised controlled trial (RCT) aimed to establish the feasibility of a main RCT of the effects of the DHI compared with standard care on long-acting contraception use.
View Article and Find Full Text PDFObstet Gynecol
February 2025
Department of Cardiology, the Department of Obstetrics and Gynecology, and the Division of Research, Kaiser Permanente Northern California, and Graduate Medical Education, Kaiser Permanente Oakland Medical Center, Oakland, and the Division of Research, Kaiser Permanente, Pleasanton, California.
Objective: To investigate the effects of the Affordable Care Act (ACA) and its elimination of cost sharing on contraception utilization, pregnancy rates, and abortion rates.
Methods: We conducted a retrospective cohort study within a health care system serving more than 4.5 million insured members across 21 medical centers and 250 clinics.
PLoS One
January 2025
Nottingham Centre for Public Health and Epidemiology, School of Medicine, University of Nottingham, Nottingham, United Kingdom.
Background: This scoping review aimed to understand the extent and type of evidence in relation to sexual and reproductive health needs of women with severe mental illness (SMI) in low- and middle-income countries (LMIC) and to summarise those needs.
Methods: Inclusion criteria were 1) focus on sexual and reproductive health needs 2) women or girls with SMI, professionals, caregivers of women with SMI and community members 3) study set in a LMIC 4) peer reviewed literature (no restriction on study date or design). Studies were identified from comprehensive searches of Medline, EMBASE, CINAHL and PsycINFO (to July 2023).
This study examines an inconsistency between an attitude and a behaviour: non-use of contraception among people who are trying to get pregnant. More than one in four people in that situation report using contraception 'sometimes' or 'always' and consequently face the risk of pregnancy. We test three potential explanations: acceptability of having (further) children; perceived low pregnancy risk; and perceived social pressure.
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