THE first male contraceptive ever to get beyond clinical trials is about to be introduced in hospitals in India. A single injection of the new contraceptive appears to work for up to a decade, but can easily be reversed if desired.
After the Indian Council of Medical Research reported successful preliminary results from advanced trials involving 500 men, the government announced last week that selected centres will offer the procedure. Volunteers must be healthy and have two children, and couples must agree to regular check-ups.
The contraceptive may bring men back to the forefront of India鈥檚 efforts to limit its vast population. Until the 1970s, more vasectomies were performed in the country than female sterilisations, says Amulya Ratna Nanda, secretary at the Ministry of Health and Family Welfare in New Delhi. Then Indira Gandhi鈥檚 government forced mass sterilisations on men in 1976. Hundreds died of infections after botched operations, leading to widespread rioting and the fall of the government. Since then vasectomy has never been a serious contender, says Nanda. Women now undergo 97 per cent of all sterilisations in India.
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But Nanda believes the new contraceptive will reverse this trend. Called RISUG, for Reversible Inhibition of Sperm Under Guidance, it has been developed by Sujoy Kumar Guha at the All India Institute of Medical Sciences in New Delhi and his colleagues.
It consists of a styrene maleic polymer dissolved in dimethyl sulphoxide, and is injected into the vas deferens, the tubes that carry sperm from the testicles to the urethra. The chemicals coat the walls of the tubes, but do not block them. The researchers think the chemicals form negatively and positively charged complexes on the tube walls, rupturing the membranes of sperm as they swim by. By contrast, most other male contraceptives being developed consist of hormone pills or implants.
According to Guha, a 60-milligram dose of RISUG is still effective in men injected a decade ago. And because the vas deferens remains intact, the procedure is easily reversed. The contraceptive can be flushed out by injecting sodium bicarbonate or by manipulating the vas deferens. 鈥淏ut it鈥檚 not so easy that it can happen automatically or that a person can do it by himself,鈥� says Guha.
In the 1980s, the National Institutes of Health in the US raised concerns that RISUG could be carcinogenic, but Guha says there鈥檚 no evidence for that. Apart from swelling in the scrotum that subsides within a few weeks, the drug seems to have no adverse effects. And Guha says it鈥檚 100 per cent effective when correctly inserted into the vas deferens.
World Health Organization officials from Geneva visited Guha in February, and countries such as Canada are also interested in the contraceptive. 鈥淚 hope to be involved in an advanced clinical trial of RISUG as soon as approval is obtained,鈥� says Barry Rich of the Surrey Memorial Hospital in British Columbia. 鈥淚 wish they鈥檇 come up with a sexier name,鈥� he adds. 鈥淗owever, I like to think it鈥檚 the steak and not the sizzle that counts.鈥�