[Contraception with steroids in the male. Experimental basis]

Inhibition of spermatogenesis is possible with many types of steroid hormones. Theoretically they could be used alone or in combination for male fertility control.

Oral active androgens or anabolic steroids when given in doses needed to inhibit spermatogenesis are liver toxic. Injections or administration of depot preparations every 14 days or 4 weeks is not practicable. Azoospermia or oligozoospermia does not occur immediately and examination of the ejaculate would be necessary to be sure whether and when azoospermia is achieved. Patients with oligozoospermia are not always infertile. It is known from animal experiments and from prostatic carcinoma patients that after long term suppression of pituitary function by treatment with steroid hormones the hypothalamic pituitary system becomes adapted to the high hormone levels and starts to secret gonadotrophins again. Consequently spermatogenesis is no longer fully inhibited. Regular controls of the ejaculate would be necessary to be sure, that azoospermia still persists. Spermatogenesis is also inhibited by synthetic progestogens. As compared with the doses in oral contraceptives, the doses needed for inhibition of spermatogenesis are at least 10x higher. When given alone there is also a loss of libido and potency which demands additional substitution with androgens. Concerning antiandrogens it will not be possible to find a dose for men which is reliably antifertile but which does not affect other androgen-dependent functions including libido. GnRH-agonists and antagonists have to be combined with an androgen. But there are some other still unsolved problems.

A method for fertility control in men based on steroid hormones will not be realized in the next future.