Heated briefs, ring… promising methods of thermal contraception

2024-01-08 16:59:09

“Heated briefs”, contraceptive ring… Alongside the search for chemical molecules, hormonal or not, male contraception could use another approach, thermal. In principle, the blocking effects on spermatogenesis of an increase of a few degrees in the testicles have been known for decades. And, in practice, more and more men are using devices – often in a homemade setting – which allow the testicles to be raised to the level of the beginning of the inguinal canal, to get contraceptives. For the moment, there has been no validation by the health authorities, but the situation could well change in the coming years.

If the story begins in India in the 1930s, with the experiments of Swiss doctor Martha Voegeli showing a drop in male fertility thanks to daily hot baths, it is especially in France that it continued to be written . In Toulouse first. In the 1980s, the andrologist Roger Mieusset and the reproductive biologist Louis Bujan were part of an association of men who considered questions of paternity, male contraception, etc. “In this group, a farmer who spent a lot of time on his tractor told us that he felt his testicles risingremembers Louis Bujan. This is how Roger Mieusset, who was already working on the subject of hyperthermia and its negative effects on spermatogenesis, came up with the original idea of ​​suitable underwear. In 1987, he published the method. » In 1994, the two Toulouse doctors reported in theInternational Journal of Andrology the results of a preliminary study – involving nine couples, and more than 150 cycles – which suggest that these briefs are an effective, well-tolerated and reversible method of contraception. To cause a drastic drop in spermatozoa (below the threshold of 1 million/ml of sperm), it must be worn for at least fifteen hours a day. For his part, the Egyptian researcher Ahmed Shafik published in 1991 comparable results in around thirty men with (reversible) testicle suspension surgery.

“A lot of requests”

In the years that followed, this research would not go much further, due to a lack of interest from other teams and industrial partners, to replicate clinical studies and conduct them on larger populations. The concept is not taken very seriously. “I find it a shame that an industrialist did not take the subject head on after Doctor Mieusset had patented the device. We would have had something standardized, which meets a growing demand”, regrets Professor Bujan. A movement also underlined by the general practitioner and andrologist François Isus, who succeeded Roger Mieusset within the medicine and reproductive biology department of the Toulouse University Hospital. In France, sterilizations by vasectomy have even increased tenfold in around ten years, more than 21,000 were carried out in 2021. “I have a lot of requests for thermal contraception, and limit myself to 5-10 consultations per weekspecifies Doctor Isus. I cannot prescribe it, since it is not recognized, but I provide information, examine these men to check the absence of contraindications, and perform a spermogram. » Afterwards ? Those who wish can, under their own responsibility, make suitable underwear or obtain a contraceptive ring (currently on sale as a decorative object). “A control spermogram would be necessary every three months, but the majority do not have follow-up”continues François Isus, who says he is thinking about a new clinical study protocol.

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