A multicentre study investigating subcutaneous etonogestrel implants with injectable testosterone decanoate as a potential long-acting male contraceptive.
BACKGROUND
The combination of etonogestrel implants with injectable testosterone decanoate was investigated as a potential male contraceptive.


METHODS
One hundred and thirty subjects were randomly assigned to three treatment groups, all receiving two etonogestrel rods (204 mg etonogestrel) and 400 mg testosterone decanoate either every 4 weeks (group I, n = 42), or every 6 weeks (group II, n = 51) or 600 mg testosterone decanoate every 6 weeks (group III, n = 37) for a treatment period of 48 weeks.


RESULTS
One hundred and ten men completed 48 weeks of treatment. Sperm concentrations of <1 x 10(6)/ml were achieved in 90% (group I), 82% (group II) and 89% (group III) of subjects by week 24. Suppression was slower in group II, which also demonstrated more frequent escape from gonadotrophin suppression than groups I and III. Peak testosterone concentrations remained in the normal range throughout in all groups. Mean trough testosterone concentrations were initially subphysiological but increased into the normal range during treatment. Mean haemoglobin levels increased in group I, and a non-significant increase in weight and decline in high-density lipoprotein cholesterol was observed in all groups. Fourteen subjects discontinued treatment due to adverse events.


CONCLUSIONS
Subcutaneous etonogestrel implants in combination with injectable testosterone decanoate resulted in profound suppression of spermatogenesis that could be maintained for up to 1 year. Efficacy of suppression was less in group II, probably due to inadequate testosterone dosage. This combination has potential as a long-acting male hormonal contraceptive.
Brady
B M
BM
Centre for Reproductive Biology, University of Edinburgh, Edinburgh EH16 4TJ, UK. brian.brady@luht.scot.nhs.uk
Amory
J K
JK
Perheentupa
A
A
Zitzmann
M
M
Hay
C J
CJ
Apter
D
D
Anderson
R A
RA
Bremner
W J
WJ
Pollanen
P
P
Nieschlag
E
E
Wu
F C W
FC
Kersemaekers
W M
WM
D000279:Administration, Cutaneous; D000293:Adolescent; D000328:Adult; D001519:Behavior / Q000187:drug effects; D003272:Contraceptive Agents, Male / Q000008:administration & dosage* / Q000009:adverse effects; D003692:Delayed-Action Preparations / Q000008:administration & dosage* / Q000009:adverse effects; D017135:Desogestrel / Q000008:administration & dosage* / Q000009:adverse effects; D005640:Follicle Stimulating Hormone / Q000097:blood; D006801:Humans; D007986:Luteinizing Hormone / Q000097:blood; D008297:Male; D008875:Middle Aged; D013076:Sperm Count; D013094:Spermatozoa / Q000187:drug effects*; D013739:Testosterone / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000097:blood
D003272:Contraceptive Agents, Male; D003692:Delayed-Action Preparations; C044815:etonogestrel; D013739:Testosterone; D017135:Desogestrel; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone; C041677:testosterone decanoate