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Re “Three new methods for male contraception”

Dear Sir,

The article entitled “Three new methods for male contraception” by Dr Ahmed Shafik in Volume 1, Number 4, pages 161-7, 1999 presents only Dr Shafik's own work and opinions, and ignores the extensive, current literature on the subject. For example, when dealing with his studies on testicular suspension, Dr Shafek fails to acknowledge the work of others[1] and ignores studies with the same polyester material which failed to confirm his results[2]. The unconvincing claim that the electrostatic properties of this material induced the antispermatogenic effects needs replication by an independent investigator.

In stating “androgen, alone or combined with progesterone, did not prove to be an efficient method of contraception”, only 20-year-old studies are cited, none of which examined contraceptive efficacy. Dr Shafik ignores recently published studies clearly demonstrating the high efficacy of hormonal male contraception, especially for Asian men in Asian centres[3-5], which have opened the way for a wide variety of new hormonal methods for men now being actively developed[6,7].

When promoting prolactin as a possible male contraceptive drug, Dr Shafik does not make clear that there is no clinical or animal experimental evidence to support that elevated prolactin alone, without gonadotropin deficiency, exerts any effect on human spermatogenesis.

We believe that authors should present a balanced and critical view of their field and, in this respect, trust that the attached references will help the reader to acquire a more realistic assessment of new methods for male contraception.

DJ Handelsman
Professor of Reproductive Endocrinology & Andrology
Director, ANZAC Research Institute & Department of Andrology
University of Sydney
AUSTRALIA

FCW Wu
Department of Endocrinology\= Manchester Royal Infirmary
Manchester M13 9WL
UNITED KINGDOM

References

[1]Mieusset R, Bujan L. The potential of mild testicular heating as a safe, effective and reversible contraceptive method for men. Int J Androl 1994; 17: 186-91.
[2]Wang C, McDonald V, Leung A, Superlano L, Berman N, Hull L, Swerdloff RS. Effect of increased scrotal temperature on sperm production in normal men. Fertil Steril 1997; 68: 334-9.
[3]WHO Task Force on Methods for the Regulation of Male Fertility. Contraceptive efficacy of testosterone-induced azoospermia in normal men. Lancet 1990; 336: 955-9.
[4]WHO Task Force on Methods for the Regulation of Male Fertility. Contraceptive efficacy of testosterone-induced azoospermia and oligozoospermia in normal men.Fertil Steril 1996; 65: 821-9.
[5]Waites GMH. The contribution of Asian scientists to global research in andrology. Asian J Androl 1999; 1: 7-12.
[6]Wu FCW. Male contraception- future prospects. In: Glasier AG, editor. Contraception, Bailliere's Clinical Endocrinology & Metabolism. v 10: 1. 1996. p 1-21.
[7]Behre HM, Nieschlag E. New androgen estersalone and in combination with GnRH analogs for male contraception. In: Waites GMH, Frick J, Baker HWG, editors. Current advances in andrology. Bologna: Monduzzi Editore; 1997. p 227-32.

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