[Male contraception-scientific foundations and contemporary progress]

Despite decades of assiduous inquiry and burgeoning societal demand, contraceptive options for men remain circumscribed. Women have benefitted from highly efficacious hormonal modalities, but the burden of contraceptive responsibility continues to rest almost exclusively upon them. In light of the potential sequelae of female hormonal agents and the inviolable right to bodily autonomy, the quest for safe, reversible male methods is assuming urgency.Hormonal contraception for men relies on suppression of spermatogenesis through exogenous testosterone combined with progestins. Multicenter trials employing testosterone undecanoate with norethisterone enanthate demonstrated contraceptive efficacy commensurate with oral contraceptives in women. Nonetheless, adverse sequelae-including diminished libido, dysphoric mood, and weight accrual-precipitated discontinuation of the WHO-led trial. Recent transdermal combinations (testosterone with nestorone) and novel oral androgens have exhibited encouraging tolerability.Concurrently, non-hormonal paradigms are garnering momentum. Retinoic acid receptor‑α antagonists such as YCT-529 disrupt spermatogenic differentiation, while inhibitors of soluble adenylyl cyclase transiently impair sperm motility, enabling on-demand, pharmacological fertility control. Both strategies have proven efficacious, reversible, and well tolerated in preclinical investigations; notably, YCT-529 has advanced into human trials.At present, the vanguard of innovation lies with academic consortia and philanthropic institutions rather than industry. Although a market-ready preparation remains elusive, the progress in both hormonal and non-hormonal avenues underscores the profound potential for a more equitable apportionment of contraceptive responsibility.