study<\/a> showing the proportion of Canadian vasectomy patients without children has nearly tripled since the pandemic.<\/p>\nBut men may soon have contraception options that are safer, less invasive and more easily reversible than vasectomies. New forms of male contraception are in early clinical trials in Canada, and the results are promising.\u00a0<\/p>\n
\u201cMen are \u2026 stuck with these two pretty poor options: condoms \u2026 or vasectomy,\u201d said Darlene Walley, CEO of NEXT Life Sciences, one of the biotech companies developing male contraceptives.<\/p>\n
\u201cWe don\u2019t anticipate any [side effects], and nor have we found any,\u201d she said, referring to the two products her company is in the process of trialling.<\/p>\n
Dr. Premal Patel, a urologic surgeon and co-founder of Men\u2019s Health Clinic Manitoba, says new forms of male contraception would be a welcome addition.<\/p>\n
\u201cI think having a reversible option is always advantageous,\u201d said Patel, noting it will make it easier for men to change their mind about having children.\u00a0<\/p>\n
Vasectomy reversal<\/p>\n
The burden of birth control has historically fallen most on women, but men have also long had two contraception choices: condoms, which require consistent use, or vasectomy, a surgical procedure.<\/p>\n
\u201cVasectomy is not without problems,\u201d said Patel. \u201cOne to five per cent of men experience post-vasectomy pain syndrome, and it can be pretty debilitating.\u201d<\/p>\n
There are other downsides too.<\/p>\n
\u201cVasectomy reversal can actually be pretty successful if it\u2019s done \u2026 [within] 10 years,\u201d Patel said. \u201cBut it\u2019s a long procedure \u2014 it takes two to three hours \u2026 under an operating microscope \u2026 and it\u2019s costly.<\/p>\n
\u201cAnd it may not work.\u201d<\/p>\n
Patel says some men who have had vasectomies later reconsider their decision not to have children, but often find the prospect of undergoing a vasectomy reversal too daunting.<\/p>\n
This makes the emerging forms of male contraception a potential game changer.\u00a0<\/p>\n
\u201c[I]f they took pills and gels, maybe they\u2019re more inclined to change their mind,\u201d he said.<\/p>\n
Male birth control<\/p>\n
Male contraceptives have historically proven difficult to develop, in part due to biology.\u00a0<\/p>\n
Unlike female contraception, which prevents the release of a single egg each month, the male reproductive system produces sperm continuously, at \u201cabout 100 million sperm per day,\u201d says Bernard Robaire, a reproductive biologist at McGill University.\u00a0<\/p>\n
\u201cEven if you find a method that\u2019s 98 per cent effective in suppressing sperm production or motility, it may still not significantly affect fertility.\u201d<\/p>\n
The male contraceptive products now in clinical trials include hormonal and non-hormonal pills, gels and long-acting implants.\u00a0<\/p>\n
Hormonal methods suppress sperm production by altering the body\u2019s testosterone signals, effectively \u201ctricking\u201d the brain into reducing the signals that tell the testes to produce sperm. These products commonly take the form of topical gels, applied to each shoulder once daily.<\/p>\n
Non-hormonal approaches, which include pills, long-acting gels or injectables, interfere directly with sperm development or function.<\/p>\n
\u201cSperm leave the testes looking like sperm, but they can\u2019t swim, and they can\u2019t fertilize an egg,\u201d Robaire said. \u201cThe idea is to inhibit the swimming ability of the sperm.\u201d<\/p>\n
Implant methods include non-hormonal, long-acting gels that are injected to block sperm.<\/p>\n
\u201c[They] inject a gel inside the tube that feeds the testes \u2014 the vas deferens, the one that\u2019s cut when you do a vasectomy \u2014 and that would block that tube,\u201d said Robaire.\u00a0<\/p>\n
But unlike vasectomies, this method would be easily reversed.<\/p>\n
\u201c[Y]ou\u2019d be able to inject something else that would dissolve the gel,\u201d he said.\u00a0<\/p>\n
Plan A<\/p>\n
Most of these male contraception products remain in the early stages of clinical trials.\u00a0<\/p>\n
However, Patel expects it could still take several years before male contraceptives are available in Canada.\u00a0<\/p>\n
\u201cIt looks like they\u2019re still in phase two trials,\u201d he said. \u201cSo they\u2019re probably still a few years away.\u201d<\/p>\n
Walley, of NEXT Life Sciences, says doctors have expressed enthusiasm for the company\u2019s two products: a long-acting injectable gel called Plan A and a pill for short-term use.<\/p>\n
\u201cPlan A \u2014 doctors really love it because they feel it\u2019s something \u2026 men can set and forget,\u201d she said. \u201cOur pill form is for the men who want something that they could do on-demand.\u201d<\/p>\n
Researchers and clinicians say the potential market is large.\u00a0<\/p>\n
\u201cI\u2019ve given many interviews over the years \u2014 the number of emails and calls I get [afterwards] with people who want to volunteer for the trials, it\u2019s always high,\u201d said Robaire.<\/p>\n
Walley similarly says recruiting participants for clinical trials has been a breeze.<\/p>\n
\u201cWe have doctors coming to us on a regular basis \u2026 that are very, very interested,\u201d she said.<\/p>\n
Some sources wonder whether enthusiasm among consumers will be equally high.\u00a0<\/p>\n
\u201cVasectomy is such a well-known procedure,\u201d said Patel. \u201cOften people just kind of say, \u2018OK, it\u2019s time for me to get the snip.\u2019\u201d<\/p>\n
Product uptake may depend on ease of use, he adds.\u00a0<\/p>\n
\u201cThe gel one sounds more doable,\u201d said Patel. \u201c[Compared to] patients remembering to take pills.\u201d<\/p>\n
Patel expects many couples would welcome a reversible method that allows men to share more responsibility for birth control. \u201cWomen have obviously been taking contraceptives for so long,\u201d he said.\u00a0<\/p>\n
\u201cSo I think it\u2019s valuable for men to have that option as well.\u201d<\/p>\n
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