A new vision for male contraception research and development

On June 6, 2024, the Population Council hosted the Fourth Congress of the International Consortium for Male Contraception on the Rockefeller University Campus in New York City. This Congress follows three former conferences held in Paris at the French Academy of Medicine, resulting in the publication of manifestos making a plea for the advancement of research in this field. The meeting in New York brought together the major researchers in the field. Many actors in this process attended the meeting, from scientists exploring new mechanisms of action to innovative manufacturers, dedicated providers, and communicators with creative market insights.

The Congress included state-of-the-art reviews of potential male nonhormonal and hormonal contraceptive methods, including the most advanced hormonal method—a transdermal male contraceptive gel nearing completion of a phase 2b trial—and modified androgens in early dose-finding testing as a potential first oral hormonal contraception for men.

With advances in the understanding of the molecular and cellular mechanisms of the regulation of spermatogenesis and sperm maturation, several promising nonhormonal targets have been discovered, a few of which were reviewed at the meeting. These methods target a specific protein, receptor, or enzyme that, when inhibited by small molecules, will lead to reversible infertility. One of these products has reached the first human trial stage and was presented at Congress, as well as advances in other approaches, including novel nonsurgical reversible vasectomy techniques.

This research has been funded over the past years by the government and not-for-profit organizations. Hormonal contraception for men was largely supported by the World Health Organization, Human Reproduction Special Program, and the Population Council, in collaboration with the strongest and continuous support from the Contraceptive Development Program and Clinical Trials Network of the Eunice Kennedy Shriver National Institute of Child Health and Human Development. The institute also supports research in identifying and developing new targets of male contraception, and emerging research on several new leads was presented at the meeting.

Numerous studies have repeatedly demonstrated a high level of interest among men to share the responsibility of contraception with their partners; now, there is a corresponding growing interest in commercial entities to engage in this field. In addition, advocacy groups have emerged during the last decade to highlight the need and demand for male contraception, including the International Consortium for Male Contraception, organizing this Congress with the Population Council, and the Male Contraception Initiative, which supports some of the early research on methods and also demands for male contraception. Most recently, a survey by Desire Line, funded by the Bill & Melinda Gates Foundation and Male Contraception Initiative, has shown strong interest in men to use novel methods once they reach the market.

Despite significant work on male-targeted products, there have not yet been any new products approved for male contraception. There is regulatory uncertainty that must be overcome in the development of products for this indication. Further public discussions with regulatory bodies are needed to provide guidance to industry on the type and amount of evidence that will be required for a marketing application. During this meeting, we have seen the growing interest in male contraception research, such that it is no longer a utopian dream but an established reality.

We thank the editorial board of Contraception for opening the columns of this very specialized journal, which is read by all those interested in contraception worldwide. In this open issue of Contraception X, presentations of the key lectures of the symposium are published. We believe these papers will become major references in the field.

Author Contributions

All authors have provided substantial contributions to the writing of the manuscript.