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Edinburgh. next to the Meadows and in the midst of leafy abundance, the Reproductive Biology Unit of the Medical Research Council is the only centre in Britian actively engaged in work on Male Contraception (although work has been done in Germany, France and USA). It will possibly lead. in time. to the development of an oral contraceptive for men the male pill.

Unlike research into the female contraceptive pill. developed in the Fifties and Sixties. which was made possible by the investment oflarge sums of money from the pharmaceutical industry and also private concerns. this has been financed by public-funded bodies. the WHO and the Population Council in America.

Lack of money is one of the reasons why we have not had a male pill before. The pharmaceutical companies recognising the commercial potential of the female pill have invested in projects all over Britain. At the time it was one ofthe major areas of research and was developed very quickly. Millions of pills were manufactured in hundreds ofbrands and they yielded huge profits. There was also investment by private individuals and philanthropists. and it was part of a movement which saw the pill as very important in giving women the

choice of how many children to have '

and when to have them if at all. However. many American pharmaceutical companies have been wiped out by litigation suits and as backers of contraceptive projects they have virtually withdrawn from the field. The risk from a product to a presumably healthy section of the public is too great and the inability to persuade the companies of the project‘s viability has been a great stumbling block to research. Of the £5 million spent world-wide in 1979. resulting in new methods ofbirth control, 6 per cent was assigned for male-based methods. 71 per cent for female.

With the current number of unintended births (200.000) and abortions (up to 140.000) in Britain. together totalling a figure equalling the population of Bristol. there is no lack of need. According to a general household survey. carried out in 1983. at the request ofthe DHSS. amongst the female population of reproductive age (16-44 years). published last December. men

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Hard to swallow Sally Kinnes on revolutionary male contraception.

Would you be more careful if it was you that got pregnant? account for only 25 per cent of those

using contraceptives— a total of53 per cent (men and women) use some form of birth control and 22 per cent (12 per cent women and 10 per cent men) have been sterilised. The remaining 25 per cent are infertile. pregnant. trying to get pregnant. or at risk.

Saatchi and Saatchi‘s famous pregnant man poster (‘would you be more careful ifyou were the one that got pregnant") tried to alert men to share responsibility for birth control. but there has always been a lack of options for men limited to the irreversible. unsatisfactory or paid for. Although condoms are available for most men from Family Planning Clinics. in 1975 GPs elected to exclude the provision ofcondoms from the Family Planning Service. Men are referred to Family Planning Clinics but are apparently very reluctant to go and embarrassed when they get there. As a result some 115 million condoms were



bought in 1984. worth some £4 million. As part ofa study researching the difficulties of obtaining them on the NHS in 1981. Whittackcr. a young male medical student. assessed 12 Family Planning Clinics and found them generally offputting. He was evenaccused of ‘trying to obtain condoms for resale‘. although Family Planning Clinics have. and are doing a huge amount to make men feel more at ease. Under-researched and under-funded. it is perhaps not surprising that little is known about the mechanism controlling sperm production. and medical knowledge of testicular physiology is apparently primitive. In women the components are more manageable. One egg a month is at least a quantifiable amount. For twenty-five years women have been working their cyclical way around little foil packets ofbirth control pills. putting a chemical preparation between themselves and babies not without some risk. In the male. the reproduction process is ‘more dynamic‘. with thousands ofsperms being produced every second. The average ejaculation contains 300 million sperms.

The experiments being conducted in Edinburgh by Dr Wu. a clinician specialising in the study ofmale fertility. are directed at suppressing the number ofsperms produced and impairing the function ofthose that are left. Experiments have been conducted since last October for which ten male volunteers (of proven fertility) have been injected with a hormonal preparation over a three-month period. This apparently j

reduces the number ofsperms ' produced to about 5 or 10 per cent. These 5 or 10 per cent are at their least responsive as fertilising components and are in fact sufficiently incapacitated to be infertile. The fertilising ability ofthe semen is tested on surrogate human eggs (hamster eggs). The method reverses itselfvery quickly, with primitive stem cells maturing to spermatozoa in seven days. What every volunteer wants to know is how it will affect their sex life and libido. To avoid loss of libido _— and none was reported in the experiments. nor apparently any other side¢effects -— testosterone, male hormone is included in the injection. This replaces what the testes are temporarily being prevented from producing. and it has always been very difficult to separate two of the factors involved in male reproduction, the production of sperm and the production of male hormone. and the basis ofthis preparation is to suppress the pituitary gland which normally stimulates the testes.

What is not known. however. is the extent to which it is necessary to suppress the number of sperms to achieve infertility. Although it only requires one sperm to fertilise one egg. it‘s still not certain whether a ‘cloud‘ of sperm is necessary to raise the enzyme level sufficiently to digest the envelope surrounding the female egg. Another approach is also being tried at the research unit in Edinburgh by a team led by Dr John Aitken. This is immunologically-based and is quite different from the hormonal-based system. Ofthe two studies it is thought that the hormonal method is likely to be more successful and although we are so many years away from it. it could become available as a male pill. an adequate reversible means of reducing the 2 3 million sperms.


Oral contraception for men


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The List 27 June 10 July 35