Spermatogenetic inhibition in men taking a combination of oral medroxyprogesterone acetate and percutaneous testosterone as a male contraceptive method  

Oleh:

Soufir, J.-C. ; Meduri, G. ; Ziyyat, A.

Jenis: Article from Journal - ilmiah internasional
Dalam koleksi: Human Reproduction vol. 26 no. 07 (Jul. 2011), page 1708-1714.
Topik: FERTILITY; Male Contraception; Spermatogenesis; Testosterone; Medroxyprogesterone; Gonadotrophins

Ketersediaan

Perpustakaan FK Nomor Panggil: H07.K.2011.01 Non-tandon: 1 (dapat dipinjam: 0) Tandon: tidak ada

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BACKGROUND We previously demonstrated in a small pilot study that oral medroxyprogesterone acetate and percutaneous testosterone (OMP/PT) induce reversible spermatogenesis suppression. The aims of this study were to determine the rate of spermatogenetic inhibition and recovery and to obtain preliminary data on efficacy for a larger population under OMP/PT. METHODS A total of 35 healthy men with normal spermiograms requesting male hormonal contraception were treated with OMP (20 mg/day) and PT (50–125 mg/day) for periods up to 18 months. Couples were included in a contraceptive efficacy phase after a value of =1 million/ml spermatozoa was reached between 1 and 3 months of treatment. RESULTS Sperm counts decreased by 47% at 1 month, reaching 90% at 2 months and 98–100% between 4 and 8 months. At 3 months, 80% of men had =1 million/ml spermatozoa. Follicle-stimulating hormone and luteinizing hormone decreased to 35% of pretreatment levels after 1 month of treatment and to 75–80% at 2 and 6 months, respectively. Plasma testosterone and estradiol levels were in the eugonadal range at 3, 6, 9 and 12 months of treatment. Dihydrotestosterone concentrations were 2–4 times higher than pretreatment values. The rate of spermatogenetic recovery was rapid (73 ± 29.5 days). During the efficacy phase (211 months for 25 couples), one pregnancy attributable to poor compliance of the male partner was observed. CONCLUSIONS OMP/PT efficiently inhibits spermatogenesis in 80% of men, maintains testosterone at physiological levels and avoids the need for parenteral administration, which is poorly accepted by French men. These results justify larger studies to define a more adequate dosage of OMP/PT and to confirm its efficacy and safety.

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