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  • Title: [Contraceptive development for the future].
    Author: Zatuchni GI.
    Journal: Contracept Fertil Sex (Paris); 1984 Jun; 12(6):769-79. PubMed ID: 12313176.
    Abstract:
    This article provides background on worldwide contraceptive usage as an introduction to its main topic, new methods of fertility regulation now under development in terms of their intervention in specific reproductive processes. A large number of chemical compounds and steroidal or nonsteroidal pharmacologic agents have been shown to interfere directly of indirectly with the processes of spermatogenesis, but most are associated with undesirable side effects. Nitrofuranes, alpha-chlorohydrine and othr chlorinated sugars, cyproterone acetate, estrogen, progestins, testosterone alone or in combination with other hormonal agents, and the cotton seed derivative gossypol have all been tested. Although research on some of them continues, questions questions of side effects, toxicity, and reversibility have arisen. Luteinizing hormone releasing hormone analogs and especially antagonists offer promise as a male contraceptive use in conjunction with testosterone, but further research on efficacy and reversibility is needed. Percutaneous vas occlusion using chemical substances including a mixture of ethannol and formaldehyde, and occlusion of the vas by electrocautery are norsurgical techniques of vas occlusion that are expected to be more acceptable to men than current surgical techniques. Various removable devices for vas occlusion have been studies, such as silicone or nylon threads, valves of different kinds, polymers, and threads of metal, especially copper, but thus far all have posed serious technical problems. Methods under development which block sperm transport in the female genital tract include enzyme sperm inhibitors and long-acting steroids, spermicides, improved vaginal sponges, disposable diaphragms impregnated with spermicide, vaginal rings, water soluble spermicidal condoms, a latex cervical cap kept in place by suction, an intracervical device that would liberate progesterone, transcervical approaches to sterilization by occlusion of the salpingo-uterine junction using quinacrine or methylcyanocrylate, and reversible methods of obstructing the salpingo-uterine junction. Research is underway to develop IUDs that would remain effective longer and reduce incidences of bleeding and expulsion, possibly through use of substances such as quinacrine, luteolytic agents, immunologic or spermicidal substances, or antifibrinolytic agents. Long-acting methods including injectable steroids and biodegradable or non-biodegradable implants, pregnancy vaccines, and other immunological approaches are at various stages of research.
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