17th Congress of the ESC, 1-4 May, 2024, Bilbao, Spain

Abstract

Background: High unmet contraceptive needs result in nearly half of all pregnancies being unintended. Additional male contraceptive options could help, but gaps remain in assessing demand for them, essential data to inform investment.
Objectives: Measure consumer demand for novel male contraceptives and identify product attributes associated with men’s preferences.

Materials & Methods: A cross-sectional, probability-based-sample survey was conducted among 3,243 sexually active, fertile cisgender, heterosexual men aged 18-60 years in the United States, and 12,435 of these men with 9,122 of their female partners in Bangladesh, Vietnam, Kenya, Nigeria, DR Congo, and Cote d’Ivoire from May 2021 to October 2022. It assessed contraceptive use, perceptions, and sociodemographic characteristics using the NORC Amerispeak Web panel and in-person interviews in LMICs. A discrete choice experiment within the men’s survey evaluated 11 contraceptive product attributes, using conditional logit modeling to analyze preferences across 52 attribute levels. The data from partners in the 6 LMICs indicated their interest and trust in male partners‘ contraceptive use.

Results: On average, 61% of men showed interest in trying new male contraceptives in their first year of availability, with interest varying from 49% in the United States to 76% in Nigeria and Bangladesh. Form of administration and time of use were key attributes in men’s product preferences. Female partners‘ interest and trust in male contraceptive use were consistently high across geographies.

Discussion: This study reveals a strong latent demand for new male contraceptives in LMICs, highlighting market gaps and the potential of non-invasive methods to meet unmet needs, while emphasizing female partners‘ trust within the broader context of contraceptive research.

Conclusion: This research reveals a high demand for novel male contraceptives, indicating strong opportunities for their development and investment.

Abstract

Currently, nearly half of all pregnancies globally are unintended, and “unwanted” pregnancies oNen result in unsafe abor&ons, s&ll a burden in many countries. While there are several reversible female contracep&ves, liyle is available for men. Current op&ons for male contracep&on include male condoms or withdrawal, both with high failure rates, and vasectomy not easily reversible. Introduc&on of novel, cost-effec&ve male contracep&ves could have important downstream global health and economic benefits.

Advanced methods of male hormonal contracep&on include combina&ons of proges&n and androgen. These steroids result in suppression of gonadotropins leading to the suppression of sperm produc&on. The androgen replaces the suppressed endogenous testosterone and maintains sexual func&on.
The most advanced method in development is a transdermal gel delivering a proges&n (Nestorone®) and testosterone to suppress the produc&on of sperm. This method has been tested in a large efficacy and safety study in more than 400 couples willing to use the method to prevent a pregnancy, as a joint development project between the Popula&on Council and the NICHD. This hormonal male contracep&ve gel is fully reversible, and results so far are very promising.

Research must continue to develop effective, reversible options for men, to allow shared responsibility in the couple’s fertility regulation and to curb maternal mortality.

Abstract

Hormonal male contraception consists of exogenous androgens which exert negative feedback on the hypothalamic-pituitary-gonadal axis and suppress gonadotropin production. This in turn suppresses testicular testosterone production and sperm maturation. Addition of a progestin suppresses spermatogenesis more effectively in men. Recently, novel androgens as potential oral contraceptive agents are being evaluated in early clinical trials. This lecture will present the recent advances and future prospects in this important area of public health.