A lot of women have longed for an alternative family planning method that would give them a break from hormonal contraceptives and allow men to take similar responsibility. Now, scientists have come up with an alternative called Adam. ADEREMI OGUNDARE gives insights into this new option and what men think about it.
Recently, a US-based biotech company called Contraline introduced a product known as Adam, which when implanted in sperm ducts could offer a reversible alternative to condoms and vasectomies.
This implantable, non-hormonal male contraceptive has been shown in trials to last for at least two years.
The contraceptive, known as Adam, is a water-soluble hydrogel that is implanted in the sperm ducts, preventing sperm from mixing with semen.
A report by Nicola Davis, the Science correspondent on the Guardian Live, stated that the approach offers a reversible alternative to condoms and vasectomies, with the hydrogel designed to break down in the body after a set period of time, restoring fertility.
“Contraline’s phase 1 trial results show promising efficacy and safety for its male contraceptive implant, Adam, which effectively blocks sperm release for up to 24 months with no serious side effects reported.
“This is really exciting because our goal since day one has been to create a two-year-long male contraceptive – that is what the demand is for: a two-year-long, temporary or reversible male birth control. And we have the first data to show that that’s possible,” said Kevin Eisenfrats, the founder and chief executive of Contraline.
Eisenfrats said the 25 participants in the clinical trial were enrolled at different points in time, with more results expected to follow. “Its great proof of concept”, he added.
Eisenfrats said the implant was inserted in a minimally invasive procedure that took about 10 minutes and used local anaesthetic, meaning the patient remained awake.
Adam is not the first male contraceptive in development that acts by blocking the sperm ducts (vas deferens), although Eisenfrats said some other implants had used materials that did not break down in the body.
He said there was little data to show that fertility was restored after these were removed, while there were also concerns such implants could cause scarring of the vas deferens and lead to permanent sterilisation.
The results from the Adam clinical trial have not yet been published in a peer-reviewed journal and do not include data on the reversibility of the implant. However, Eisenfrats said the hydrogel had a predictable lifespan and had been shown to break down over time in animal trials, with work using lower doses in men revealing a shorter period of efficacy.
“The way to think about this is sort of like the IUD (intrauterine device) for men,” Eisenfrats said, adding that after a two-year period men could decide whether to get another implant. The team is working on a procedure to enable “on-demand reversal” Eisenfrats said, adding that sperm tests could be used by men at home to check whether the contraceptive was still effective.
Contraline said it was expecting to begin a phase 2 clinical trial in Australia later this year involving 30 to 50 participants.
In a report by Davis, Professor Richard Anderson, an expert in hormonal male contraception at the University of Edinburgh, welcomed the findings. “Its impressive that this looks like something that does actually work, which is great,” he said.
“We’ve now got hormonal and non-hormonal methods in advanced clinical development, which is potentially a much better position than we’ve been in previously in terms of actually getting something on the market for men to really use,” he added.
But Professor Richard Anderson and Professor Jon Oatley of Washington State University have stated that at present, no data had been released showing the reversibility of the Adam implant, and it remained unclear how long a single implant lasted.
Anderson also said it had yet to be shown that the implant could be removed, while Oatley said the long-term ramifications of blocking the vas deferens were unknown.
Oatley said that while the Adam implant could be a strong contraceptive option for men, uptake may be limited.
“Given a choice of a pill, patch, injectable or surgery, I believe that most men would choose pill or patch over surgery,” he said.
In a series of interviews conducted by Nigerian Tribune, some men shared their views about this new family planning method
Damilola Oduntan, an engineer, said: “I am just hearing about this for the first time. I think it’s a good development with focus on males now to ease stress on females.”
Stating his opinion, Murtala Onaade, a historian, said: “It is a good idea and I will not mind going for it, especially since it will not hinder ejaculation and the couple can still have children if they so desire. But more awareness needs to be done so that people can be well informed.”
Tosin Fadare, a teacher, said: “I am just learning about this new method. It looks good, but I think I will still prefer if it is in form of a tablet to be taken instead of an implant. Possibly after one begins to read about the success rate it can be considered.”
Opeyemi Adekola, another teacher, said: “As an African man, I’m hesitant to support this family planning method. I’m concerned about potential side effects, especially impotence. I think it’s riskier for men because it involves a procedure close to vasectomy.
I am also worried about the long-term health implications as the blocked sperm degrades and get absorbed by the body. When the hydrogel liquefies after its lifespan, I’m uneasy about its potential impact on my health. I think women have more options for family planning; so it’s better for them to explore those than come tampering with our (men’s) bodies.”
On his part, Omojola Olakunle, a mental health expert, said: “The first concern this might raise is one that surrounds the identity and masculinity of men, especially in Africa and other parts of the world where most cultures or people associate masculinity with fertility.
“From a traditional or cultural perspective, anxiety and low self-esteem issues may arise, particularly when peers or people begin to question the choice to use contraceptives as a man.”
Olakunle, while insisting that peer pressure and stigma issues can arise from this, men may feel forced to choose between social acceptance and personal or relational responsibility.”
He added: “Personally, I do not even recommend the medical types of family planning for both male and female because of cultural, medical, social, mental and psychological issues. I will advice the use of condoms, abstinence or other natural methods available.
“For the Adam project to be actualized, a lot will have to be done in the areas of education, counseling, support and more research. Come to think of it, it looks like preventing nature I wonder why they called it Adam!”
However, Dr Olalekan Ifeoluwa, a medical expert, said: “From available evidence so far, this development is a good one because it encourages shared family planning responsibility. It is offering a stress-free alternative to hormonal contraceptives for women.
“It is non-hormonal and it has mild side effects. The procedure is short and relatively painless due to the use of local anesthesia.
“Adam is more appealing because it is reversible after two years if they choose to have another child. There is no specific limitation because it is still undergoing trials.
“When more people use it and there is a good number of success rates more people can be interested in trying it out. In this situation, health education is important and one on one counseling can be considered.”