title: Spermatogenetic inhibition in men taking a combination of oral medroxyprogesterone acetate and percutaneous testosterone as a male contraceptive method.
abstract: BACKGROUND
  We previously demonstrated in a small pilot study that oral medroxyprogesterone acetate and percutaneous testosterone (OMP/PT) induce reversible spermatogenesis suppression. The aims of this study were to determine the rate of spermatogenetic inhibition and recovery and to obtain preliminary data on efficacy for a larger population under OMP/PT.
  
  
  METHODS
  A total of 35 healthy men with normal spermiograms requesting male hormonal contraception were treated with OMP (20 mg/day) and PT (50-125 mg/day) for periods up to 18 months. Couples were included in a contraceptive efficacy phase after a value of ≤1 million/ml spermatozoa was reached between 1 and 3 months of treatment.
  
  
  RESULTS
  Sperm counts decreased by 47% at 1 month, reaching 90% at 2 months and 98-100% between 4 and 8 months. At 3 months, 80% of men had ≤1 million/ml spermatozoa. Follicle-stimulating hormone and luteinizing hormone decreased to 35% of pretreatment levels after 1 month of treatment and to 75-80% at 2 and 6 months, respectively. Plasma testosterone and estradiol levels were in the eugonadal range at 3, 6, 9 and 12 months of treatment. Dihydrotestosterone concentrations were 2-4 times higher than pretreatment values. The rate of spermatogenetic recovery was rapid (73 ± 29.5 days). During the efficacy phase (211 months for 25 couples), one pregnancy attributable to poor compliance of the male partner was observed.
  
  
  CONCLUSIONS
  OMP/PT efficiently inhibits spermatogenesis in 80% of men, maintains testosterone at physiological levels and avoids the need for parenteral administration, which is poorly accepted by French men. These results justify larger studies to define a more adequate dosage of OMP/PT and to confirm its efficacy and safety.
authors.affiliation: Assistance Publique Hôpitaux de Paris, Service d'Histologie Embryologie Biologie de la Reproduction, Paris, France. jean-claude.soufir@svp.aphp.fr
authors.forename: J-C
authors.initials: JC
authors.lastname: Soufir
authors.forename: G
authors.initials: G
authors.lastname: Meduri
authors.forename: A
authors.initials: A
authors.lastname: Ziyyat
mesh_terms: D000279:Administration, Cutaneous; D000284:Administration, Oral; D000328:Adult; D003267:Contraception / Q000379:methods*; D003272:Contraceptive Agents, Male / Q000008:administration & dosage / Q000494:pharmacology*; D013196:Dihydrotestosterone / Q000097:blood; D004958:Estradiol / Q000097:blood; D005260:Female; D006801:Humans; D008297:Male; D017258:Medroxyprogesterone Acetate / Q000008:administration & dosage / Q000494:pharmacology*; D008875:Middle Aged; D011247:Pregnancy; D013076:Sperm Count; D013091:Spermatogenesis / Q000187:drug effects* / Q000502:physiology; D013739:Testosterone / Q000008:administration & dosage / Q000097:blood / Q000494:pharmacology*
chemical_list: D003272:Contraceptive Agents, Male; D013196:Dihydrotestosterone; D013739:Testosterone; D004958:Estradiol; D017258:Medroxyprogesterone Acetate