- So which one of you
have taken birth control?
- We've actually both been on birth control.
- You heard that right.
Nina and Daniel recently took part in a human test trial
for male birth control.
This is just one of a few promising options
and developments.
And this is big news
because there hasn't been a single new form
of male contraceptive
since the no-scalpel vasectomy was introduced in the 1980s
and that's mostly because of a lack of funding
and interest from Big Pharma.
So men have been left with just two options.
- Condoms and vasectomy.
- Snip snap, snip snap, snip snap.
You have no idea the physical toll
that three vasectomies have on a person.
- Yeah. Not great.
- Condoms have actually a pretty high failure rate of 13%
and vasectomy requires surgery,
so it's really important that men have more options.
- And they're coming.
Researchers are closer than ever before.
Daniel tried a hormonal gel,
but if hormones aren't your thing
there's also an option called ADAM.
- We've developed the first ever hydrogel
that we're implanting into the vas deferens
to block sperm
where it's long lasting, non-hormonal and reversible.
- Oh, and it doesn't affect sensation.
Impressive, right?
But why do we need more contraceptive options,
especially if women have about a dozen?
- I do love this question.
It's really about choice.
Making the most options available
is going to make sure that people are contracepting
to the best of their ability
because it's not one size fits all.
- And recently this effort
has taken on a new importance.
- We know that male contraception can be a part
of the solution for this problem.
Increasing the use of contraception
will decrease the number of abortions that need to be done.
So it's really important for us that we bring ADAM to market
and we give couples the ability to control their own bodies.
- Nearly half of all pregnancies are unintended,
so the current contraceptives are not meeting demand
and a lot of them have the potential for side effects
- Really bad skin sensitivity, breakouts, headaches,
worsening periods, breakthrough bleeding, weight gain,
difficulty eating, nausea, that kind of stuff.
- Three fourths of the whole world
relies on female partners for birth control.
There's a lot of responsibility
that comes down to women to be the owners
of not only contraception
but also pregnancy and family planning.
Male birth control will reduce
some of the burden that come on women.
And finally, will make men better partners.
- And it could all start with this.
- It's on the way.
We just have to be patient.
- This is "Just Might Work".
A show about surprising solutions to our biggest problems.
- My options for contraceptive
have been pretty much to choose the least worst option.
- This is Heather.
She spent the last decade doing research
and product development on female contraception.
Now she's leading the charge
to introduce male contraceptives.
- Honestly, the male and female contraceptive
development space was running neck and neck
when the pill came on the market.
There were some setbacks on the male side,
that the female pill just came to market sooner.
- After that, Big Pharma
really hasn't been interested,
considering female contraception
is a more than $5 billion industry in the US.
For example, one promising effort was cut short
by trial runners because of side effects,
even though most men in the trials said they would continue.
- Yes, contraceptive access has allowed a lot of autonomy.
We've been able to complete our educations,
start careers and time our families at our choosing.
But with that has come a great deal
of side effect challenges.
- It's so much trial and error for women
trying to figure out what the right birth control
is for them,
to like have to be restarting and starting new medications
not knowing if it's gonna be covered by your insurance.
Some of them are also like really invasive.
- To be able to trade off with a partner
would be really beneficial and a desirable option.
What we've forgotten
is that men are also reproductive beings.
So there's an opportunity to work together
to prevent an unintended pregnancy
- To tackle the funding challenge,
Male Contraceptive Initiative
supports early discovery stage products,
including this familiar sight, ADAM,
the non-hormonal injectable hydrogel
and it just might be the first solution available
to the public.
- Deep down, I'm a scientist.
- Kevin started working on male birth control
as a teenager inspired by this show on MTV.
- I was seeing that a lot of the problems
that these guys were talking about,
these unintended pregnancies,
they were blaming on condom failure
or their lack of wanting to use condoms.
- Did you use a condom that night? Didn't?
- That was like the one night.
- And all of a sudden it dawned on me,
why is there no male birth control?
With female contraception,
the drug really has to stop one egg once a month.
With male contraception,
we're talking about stopping millions
and millions of sperm that are produced every heartbeat.
And so finding a drug that's able to be really effective
in doing that is really difficult.
- Contraline's approach involves an injection
into the vas deferens,
the duct which transports sperm to the urethra.
- There were certainly attempts
to develop this occlusive device over the last 30 years,
but none of these technologies were successful.
- These ideas have varied from using polyurethane
in China in the '70s, but it was really toxic.
To using silicone rubber in Indonesia and the Netherlands,
but it was too stiff and sperm would just travel around
that rubber plug,
to using plastic polymer, which is what Risug,
out of India, is based on.
The problem with it
is that it seems to be really long lasting
and does not have good reversal data yet.
- So where does this leave Kevin and his team?
- How do you develop a material
that is really effective at blocking the vas deferens?
Be very durable but elastic, be safe and also reversible
and it's a material science challenge.
- What makes our technology unique
is that we have first non-hormonal, hydrogel based,
durable, highly biocompatible device that can be reversed.
- Prefilled syringes with the solvent.
You can see it dissolve.
So you can see the gel being dispensed now.
Then flip it over.
- So when we block the vas deferens,
we're actually just blocking those little sperm cells.
So for lack of better words, the guy is shooting blanks.
Which means that the patient will not feel
or see a difference and there's no effect on sensation.
- Contraline has already had success
with their preclinical models on canines,
so they're moving on to human trials in Australia,
which has one of the highest vasectomy rates per capita.
- Assuming all goes well in Australia,
we hope to bring the trials to the United States
either in late 2023 or early 2024.
We now have over 2700 men who are interested
in being in the trial.
The majority of men
are in this kind of 25 to 39 year old age group,
that's what we think is the target market.
- So far, the results of Contraline's
in-human trials have been promising.
We checked in with Kevin
after the first four patients were injected with ADAM.
He said they were "Discharged very quickly
after the procedure and have recovered well".
This is good news for the future of male birth control
and for the 70% of men
interested in male contraception, like Daniel.
His experience taking birth control is a hormonal approach,
funded by the National Institutes of Health.
- At the beginning there was a lot of like,
okay, what is this actually doing?
Like understanding that the gel has testosterone,
it's like being absorbed in the skin
and basically blocking your sperm production.
- NES/T is a gel that is applied
on a man's shoulder blades or upper arm every day.
It does two things, inhibits sperm production
while not affecting sexual drive or function.
The key bit of science here
is that the gel doesn't really impact testosterone levels,
which minimizes side effects.
Daniel was going into a lab at UC Davis
to regularly check his sperm count
after he started using the gel.
- The first few times I didn't notice like a huge change
but then like exponentially,
it went from like I don't know,
like 36 or something to like 19 to zero.
So I'm like, okay, I'm seeing this,
I'm looking at the chart
and I get a sense of what's happening.
So that was really reassuring.
- For Daniel and many of the couples
that have completed the trial,
the gel worked well and on top of that.
- So I didn't really have any noticeable side effects.
I may have gained some weight
but that also just could have been eating
and COVID and all the things.
The gel is pretty easy to work with.
I didn't really have any problems with it.
You have to put it on, kind of like the pill,
pretty much the same time every day
or pretty close to it.
- Daniel's sperm count still wasn't back
to normal levels when we talked to him
but the NIH says it should be
in about four months after stopping NES/T.
- Obviously we came in the study to sort of
support the research that they were doing
but we learned a lot more along the way.
I don't know how many more research studies
I'm gonna wanna do
but I think it was a good first experience for us.
- Even with such positive results
from trials so far,
it will still most likely be five to 10 more years
until we see a male birth control product on the market
and hopefully by then, there will be options.
- That's one thing that's very special
about the male contraceptive space.
It's a very small and extremely collaborative space,
so this idea of a rising tide lifts all boats,
it's really at the center of what we all
are focusing on.
- It doesn't feel like there's a race
because I don't think that every guy is going to get ADAM.
I don't think every guy is going to want hormones.
And that's the thing is that I actually hope
that 10, 15 years from now,
all of these options are on the market.
- I think that is a tremendous opportunity that we have
and I will personally fight for that,
for the run of my time here,
because when you see an opportunity to change the world,
you should take it.