The De-Sperm-inator

By Audrey Schulman, Grist.org. Posted August 19, 2003.

If you plan to have sex anytime soon, let's hope it's not in Niger, Africa. According to the nonprofit organization, Save the Children, just 4 percent of couples in Niger have access to birth control. Although the situation in this West African country is extreme, more than 125 million couples worldwide -- most of them in developing countries -- cannot get contraceptives. Some of the children that have resulted from these couplings were wanted and some were not, but one thing is certain: Lack of access to birth control increases the burden on already strained parents and on the global ecosystem.

Sujoy Guha, professor of biomedical engineering at the Indian Institute of Technology in Delhi, believes he has the answer to this problem. Highly regarded in India for his work on everything from disability rights to drinking-water purification, Guha has spent the last 25 years perfecting his invention; Reversible Inhibition of Sperm Under Guidance, better known (thankfully) as RISUG. RISUG, he says, has all the advantages of the perfect contraceptive -- and, some would say, a surprising bonus: It's made for men.

RISUG works by an injection into the vas, the vessel that serves as the exit ramp for sperm. The injection coats the vas with a clear polymer gel that has a negative and positive electric charge. Sperm cells also have a charge, so the differential charge from the gel ruptures the cell membrane as it passes through the vas, stopping the sperm in their tracks before they can even start their journey to the egg. RISUG doesn't affect the surrounding tissues because they have no charge.

Compared to the other male contraceptive choices currently available -- abstinence, withdrawal, condoms and vasectomies -- RISUG is a whole new ballgame. In fact, Guha and others believe, the contraceptive promises to be even better than the choices available to women. Guha enumerates six advantages of his invention:

• Neither sexual partner has to interrupt the throes of passion to use it -- no more running to the bathroom and fumbling with various ointments and plastics.
• The process, once it is refined and approved, will be completely non-surgical. Whew, say a lot of men.
• It's long-lasting. According to Guha, a single injection can be effective for at least 10 years.
• After testing RISUG on more than 250 volunteers, neither Guha nor other researchers in the field have found side effects more worrisome than a slight scrotal swelling in some men immediately following the injection. This swelling goes away after a few weeks. Compare that to the Pill, which even today can cause health problems ranging from severe migraines to blood clots.
• It works. Of all the men who've had the RISUG injection (and 15 of the 250 had it more than 10 years ago), there has been only one unplanned pregnancy among their partners -- and in that instance, the injection wasn't administered properly.
• Best of all, the contraceptive appears to be reversible with another injection. To date, reversing the procedure has been tried only on non-human primates, but among them, it's been reversed successfully multiple times.

If RISUG's current stage of clinical testing goes well, it will be on the market in India by next year. Within a few more years, if all proceeds as planned, the injection to reverse it will also be on the market.

Just Shoot Me!

But would men in India -- or anywhere else -- use it? Every U.S. male authority I talked to in the field, including experts at the World Health Organization and the U.S. Agency for International Development, pooh-poohed the idea. "Men don't like doctors to have anything to do with their testicles," summarized Don Waller, a contraceptives expert and professor of pharmacology and toxicology at the University of Illinois at Chicago.

Maybe not -- but one in six married men in the U.S. have had vasectomies, which definitely require medical personnel poking at the gonads.

Moreover, surveys conducted by the University of Edinburgh, the Kaiser Foundation, and other entities have shown that in countries as diverse as Hong Kong, South Africa and the U.S., the majority of men say they want more options for male contraceptives.

But even if men used RISUG, would women trust them? It's doubtful that the whispered promise of having been RISUGed would fly during a one-night stand. However, in the context of a committed relationship, RISUG could shift some of the responsibility for family planning off the women who have borne (and born) too much of it for too long, at the expense of their health, time, finances and emotions.

That shift is definitely possible, according to Ronald Weiss, a vasectomy specialist in Toronto, who says men's attitudes toward contraception are changing. "In Canada, 10 years ago, it used to be tubal ligations [the more-invasive female equivalent of a vasectomy] to vasectomies were performed at a ratio of 2 to 1. Now that number is reversed."

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