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  • Narrator: Did you know the condom

  • is over 5,000 years old?

  • That's right, some of the first forms of birth control

  • date back to around 3,000 BC,

  • and while the condom has made some strides

  • since the Bronze Age, men still don't have

  • a much better option all these millennia later.

  • Besides a vasectomy.

  • Especially compared to the pills,

  • IUDs, and implants available to women today.

  • So why don't we have birth control for men?

  • In 2002, researchers asked

  • more than 9,000 men across four continents

  • whether they'd be willing to use contraception

  • capable of preventing sperm production.

  • Over half said yes.

  • So the problem isn't lack of interest,

  • it's partly human biology.

  • Women ovulate just one or two eggs each month.

  • Men, on the other hand, produce sperm daily,

  • and it's not just one or two.

  • There's literally hundreds of millions of sperm

  • produced each day, so because there's so many

  • sperm produced, actually, you can reduce your sperm number

  • over 90% and still be completely fertile.

  • Narrator: To reach infertility, a man's sperm count

  • needs to be somewhere around 1 to 10 million

  • per milliliter, but getting there is near impossible,

  • at least without side effects.

  • That's because sperm count is tied

  • to the production of testosterone.

  • In the past, researchers tried decreasing testosterone

  • in an effort to decrease sperm count.

  • The problem is you don't have any libido,

  • you have very little testosterone to act on other tissues

  • and so forth, and so the side effects were so dramatic

  • that it really wasn't ever

  • going to be a contraceptive pill.

  • Narrator: Scientists also tried using different compounds

  • that attack the cells that produce sperm.

  • But again, biology got in the way.

  • Germ cells, as they're called, developed inside

  • a fortress-like structure within the testes.

  • So literally, nothing can get through it.

  • There's been a lot of small molecule studies

  • to try and actually attack the germ cell

  • to stop it from working.

  • Literally, I can think of 10 or 15 different compounds

  • that actually have been developed to do that,

  • but they don't work because of that barrier.

  • Narrator: But the complex male anatomy

  • isn't the only problem. It's also funding or lack thereof.

  • In 2002, two big pharmaceutical companies

  • took interest in male contraception, Schering and Organon.

  • And together they funded a large clinical trial

  • on a hormone-based contraceptive,

  • offering hope that a pill backed by Big Pharma

  • might be on the horizon.

  • Then these two companies became, as you know,

  • acquired by bigger company, and then even bigger company,

  • so now they are merged in huge companies,

  • and women's health is still a priority

  • in many of the companies,

  • but men's health became part

  • of the general matter of health.

  • And therefore, the development of contraception

  • becomes a really very low priority.

  • Narrator: According to Dr. Wang,

  • male contraception was also too risky

  • for Big Pharma at the time.

  • The long-term side effects were unknown.

  • Companies were concerned that women might not trust it,

  • and despite the survey results, it was unclear whether men

  • would actually use a hormone-based contraception.

  • Today, the limited funding comes mostly from

  • government agencies like the National Institutes of Health.

  • But there are in fact some promising lines of research.

  • Dr. Wang is working on a gel that can lower testosterone

  • where it matters, in the testes where sperm is produced,

  • while keeping testosterone levels normal elsewhere.

  • That means low sperm count and, more importantly,

  • no major side effects.

  • We have preliminary studies to show

  • that if we give the gel and if the man applies the gel,

  • 90% of the men will reach the level that you talk about,

  • 1 million per mil.

  • And Skinner is pursuing a new approach,

  • shutting down Sertoli cells,

  • which are a part of that impenetrable barrier

  • that houses germ cells.

  • So if you shut down the Sertoli cell,

  • then you shut down the sperm production.

  • Narrator: But perhaps most promising

  • is a sort of reversible vasectomy that's in the works.

  • So they have this ability to inject this gel

  • into what's called the vas deferens,

  • and it makes this plug, so then essentially

  • it does the same thing, but you're not cutting it.

  • Then believe it or not, you can actually

  • inject this chemical mixture, which will dissolve the plug,

  • and so then you can get your fertility back.

  • Narrator: But as promising as these approaches may be,

  • they're still years, if not decades, out, Skinner says.

  • And without more funding, some of them

  • may never hit the market.

  • So at least for now, men are left with few options.

  • Irreversible vasectomies, pulling out ,

  • and that slightly updated Bronze Age invention.

Narrator: Did you know the condom

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