Male Contraception Just Had A Big Breakthrough — But Is An Actual Product Near?
When you think "male contraception," you probably think "condoms;" but scientists have long looked for more comprehensive methods for men to control their fertility in similar ways to women. The science has hit many snags. One particular obstacle is the difficulty of controlling millions of sperm as opposed to one egg, but, as I pointed out in and article on the future of male contraception in 2015, more often the obstacle is funding. Well, a new scientific breakthrough might be the push that male contraceptive methods need (or it might not). Scientists have discovered that peptides, chains of amino acids, might be the key to cracking artificially affecting male fertility, from the sperm up.
The "male pill" is, realistically speaking, still many years away, but that doesn't stop media hype from following every new discovery and hint of a possible solution. The reality of actual drug development is, unfortunately, one of grindingly slow progress, lack of funding, and false starts; but it would be excellent for men around the world if this latest bit of science were different. Male fertility control is a feminist issue; it means the onus for protecting against pregnancy on a long-term basis isn't just the woman's job, and that men can take greater responsibility for family planning (and, in the case of this proposed therapy, maybe even get treated successfully for their own fertility issues).
Condoms ain't enough, and the new science may be the next link in the chain towards a set of comparable contraceptive options for men and women. Bustle spoke to Professor John Guillebaud, who has worked in the field of male contraception since the 1970s, for an expert opinion on this method and the future of male contraception in general.
I'm going to use the word "penetrating" a lot, so get the sniggers out of the way. You ready? OK. The new research from scientists at the University of Wolverhampton, UK, is unusual in that it's been released at the start of a research program, not at the end. Wolverhampton scientists are setting out on a three-year journey with hundreds of thousands of pounds of funding, to explore whether cell-penetrating peptide technology is the future of male contraception and fertility treatment. Their initial signs, they say, look pretty hopeful. This might be an attempt on the behalf of the scientists to rustle up commercial interest: if their method can be proven to work precisely, drug companies might be interested in marketing it. (Might.)
The research from the Wolverhampton scientists is based on cell-penetrating peptides, which are fascinating little things. Discovered only in the past few decades, cell-penetrating peptides are essentially like delivery systems: they can get into the interior of basically any cell in the body through its plasma membrane without destroying it or getting trapped in the outer layers. They can also carry "cargo" into the cell's interior. Using them, scientists hope to be able to deliver drugs accurately and do specific cell repair work; imagine the tiniest injection needle imaginable.
When it comes to male contraception, though, the cell-penetrating peptides are only part of the story. The Wolverhampton scientists discovered back in 2013 that they could create cell-penetrating peptides that were "bioactive" on their own, rather than just inert vehicles for bigger stuff. They called them "bioportides," and it's those that might stop sperm in its tracks — by making them stop swimming.
Sperm "motility," as it's known, is a crucial part of the fertility of dudes; if sperm are hanging around inert, they're not capable of going on the journey to the egg that will result on pregnancy. (The copper IUD deals a blow to sperm motility in its own way: it severs the sperm's head from its tail.) The Wolverhampton scientists have apparently developed a "bioportide" that stops sperm dead. "Ironically," one of them said in a press release, "sperm are notoriously difficult to penetrate, but with cell penetrating peptides we are now able to cross an otherwise impermeable barrier to manipulate the intracellular biology of sperm so as to enhance or inhibit motility." In other words, they can use their new weaponry to fiddle with how sperm move.
How would this work in a contraceptive context? Stopping sperm moving with the innovation, which could be delivered via a nasal spray or pill, would probably only work temporarily, but long enough for a man to be covered from causing pregnancy if he had sex (though not protecting against the spread of sexually-transmitted disease). Squirt! You're ready to go out and have some strings-free sexin' without any worries about contraceptive consequences.
Guillebaud tells Bustle that, "in principle," he believes the idea was a good one, as lack of motility is actually "a much better idea than a method that stops spermatogenesis, the production line for sperm, because it takes 70 days to achieve infertility by stopping that." He emphasizes that "flexibility and reversibility" are the great aims of temporary, rather than permanent, male contraception: if a man took it, "that night he would know he was safe from making a woman pregnant but, if he did not take any additional doses, his fertility would return in a few days' time."
There are several fascinating things about the whole idea of stopping sperm with the help of sperm-invading protein chains. One is that the scientists also think they can use their discovery to help male infertility, setting sperm swimming when they've just been laying flat and spurring better chances of pregnancy. Treatment for male infertility is hardly prone to fixing all issues spontaneously; Planned Parenthood offers hormone treatments, surgery, IVF and a process called "intrauterine insemination," where viable sperm are collected from a man and directly injected into the uterus to try and reduce the margin for error. It's not often that a technology could be used to both prevent babies and encourage them.
Another is that work has been done on cell-penetrating peptides and sperm before; a study in 2013 found that it was pretty tricky to use the delivery system to put "large proteins" inside the sperm to try and impact anything. The train, in other words, couldn't quite fit through the tunnel; sperm were just too tricky. The new idea of these "bioportides" might change the way we think about changing the interiors of cells in other ways, too. Think sneak submarine rather than giant cargo loads. One of the Wolverhampton scientists has already had some luck using them in preliminary studies for treating Parkinson's disease.
Why "One Step Closer" Is Still Many Steps From The Finish Line
The media has reported this as being "one step closer" for the beginning of the male contraceptive pill or spray, long a pipe dream for specialists. It may also be a better option for some men than Vasalgel, which is shaping up to be one of the first new male contraceptives on the market in decades. Vasalgel, which will hopefully be released to men in 2018 after years of research by the Parsenus Foundation, is an injection into the ball sac; in trials on rabbits released this year, those with Vasalgel were found to be unable to cause pregnancy for an entire year. (Parsenus haven't yet scheduled clinical trials in humans, which are essential before the contraceptive can actually be marketed, so don't put a date in your calendar just yet.) It's designed to be a long-term option with the necessity of visiting a GP; the "bioportide" option, which will likely last for far less a time, will possibly be less invasive, though we don't know yet.
Another issue is side effects. Another male contraceptive has made headlines this week: a hormonal injection developed by endocrine specialists. And while the shot itself was shown to be 96 percent effective in continuing to prevent pregnancy in the male subjects' female partners, a large proportion of the men reported side effects: acne, libido swings, pain and other issues. There were 1,491 reported side effects, of which 39 percent were judged not to be related to the drug at all. It's a bit like the pill: hormonal fiddling can create some serious issues. And we're not yet at the stage where human tests of the peptide-based model can demonstrate if there are any associated issues.
The biggest problem is whether any male contraceptive options can get the funding to make them a reality in a reliable way. Drug development takes more than just science; it takes a lot of money from interested companies, who just might not believe that men are that interested in contraceptive options. Guillebaud encourages people to be very cautious about the hype.
"Especially since the economic downturn," Guillebaud says, "potential investors have become reluctant to support research into contraceptives, particularly into male contraceptives. They have become more risk-averse. Even with adequate funding — millions of dollars — it will be likely 10 years, sadly, before a male method results, given the need for human testing (dose finding, efficacy and safety testing in phased trials)."
Various different, promising ways to inhibit male fertility have been discovered over the years, from Guillebaud's "dry orgasm" pill to a drug that would stop sperm ever reaching full maturity, and even a study in 2013 that found injecting gold into the testes had a contraceptive effect (of course they would try that). Thus far, with the exception of Vasalgel, many of them have remained on the drawing board or stuck in testing. Guillebaud explains that this is often cultural as well as economic, highlighting obstacles like "the widely-held myth that men cannot be trusted to remember to take a contraceptive pill," the "perception that the female pill is a better solution, because women have the greater motivation to avoid pregnancy," and "the belief that men won't want to take a contraceptive drug that might have side effects."
So don't start planning your male friends' new Christmas presents around non-baby making just yet. This is a promising start, but it still remains to be seen whether it ever makes it to the finish line, so to speak. "I think when a male contraceptive pill or implant does hit the market," Guillebaud said, "it will be huge." But we're still, alas, a very long way off.
Image: Bustle; Giphy