Men may choose their own contraceptive method for a variety of reasons, but perhaps none more important than relieving themselves of the emotional and financial burden unwanted pregnancies bring.
Family planning methods for men either prevent sperm from leaving a man's body, block it from entering a woman's body, or render sperm immotile or interfere with its ability to fertilize an egg.
Abstinence
Abstinence is the least invasive and one of the most effective methods of birth control. But not everyone can maintain this practice. The problems lack of sexual contact can cause a relationship concerning intimacy and happiness are barriers to the success of this strategy.
Condoms
Condoms act as a physical barrier between sperm and the woman's reproductive organs. Condoms can tear and carry an average 14 percent failure rate. Because the condom sheaths the entire penis, one of the chief complaints concerning its use is a reported lack of sensation.
Caution also must be taken in handling the used condom to prevent transmitting sperm from the condom, or objects in contact with the condom, to the woman's genital area.
The Pill
The most promising combination currently in development for a male contraceptive pill involves either the synthetic hormone desogestrel, or gestagen, along with testosterone. During trials, sperm counts have been found to drop to zero, making the pill more effective than almost any other form of contraception.
It carries almost no side effects, with only minor weight gain reported in a small number of men for the desogestrel version. There have been reports of reversible shrinkage of the testicles in the gestagen combination.
The biggest drawback to this method is the need to take a daily pill. Research is underway on an implanted version, as well as a cream and patch.
Cost is expected to be equivalent to that of condoms. The results are reversible, but the drop in sperm count may take from a few weeks to four months to occur.
IVD
An Intra Vas Device is a series of silicone plugs, sutured to the wall of the vas deferens, the passageway of the system that carries sperm from the testicles to the urethra. The device was designed to stop sperm from passing outside the body. The effects take place relatively quickly, within a few ejaculations.
Setbacks in development have included leakage as the vas deferens duct expands around the plugs. While the sperm count achieved is low enough to be considered infertile and the escaping sperm were rendered mostly immotile, increasing the number and size of the plugs are being considered to better these results.
This method is preferable for those who wish to avoid more invasive methods of contraception. It is easy to reverse; however, damage from pressure, which may affect future fertility, is a concern. The potential for this increases with the length of time the plugs are in place.
RISUG (SMA)
Reversible Inhibition of Sperm Under Guidance uses a polymer in part to physically block the vas deferens passage, but through charges present on the surface, it also renders sperm immotile.
There is less concern about leakage, so a smaller amount of material can be used than with plugs and there are fewer concerns with pressure or its resulting damage.
This method is almost immediately effective, reversible and considered minimally invasive, as it is accomplished through an injection. Reversal is slightly more invasive.
Chemical Sterilization
Chemical sterilization is a mildly invasive procedure where an injection introduces chemicals into the vas deferens. The resulting scarring prevents sperm from passing from a man's body.
Drawbacks to this method include a waiting period of several months for its effects to be realized. This form of sterilization is on par with the vasectomy in rates of reversal because of the unpredictable amount of scarring.
Vasectomy
Vasectomy remains one of the most invasive forms of male contraception, despite much progress over the history of the surgery. While the procedure is considered a minor surgery and done on an outpatient basis, it involves cutting, cauterizing and suturing of the vas deferens. The failure rate is considered to be low.
The biggest drawback for most men is mental or emotional trauma and the effect on their perception of manhood. After a vasectomy, sperm is eventually seen as an invader and the body will begin to form antibodies against it. This can lead to blockages or ruptures in some cases.
Vasectomy has a better rate of reversal with advances in microsurgery, however reversal is expensive and may not restore fertility.
