Women have multiple options for preventing pregnancy but men have only two - vasectomy, which is usually permanent, and condoms, which can become tiresome in long-term relationships. For decades, pundits have predicted new contraceptives for men within the next 5 to 10 years but new technology at the second "Future of Male Contraception" conference says new solutions may finally be close:

a) Researchers from the University of Washington used testosterone gel, which is marketed for men with low testosterone, plus a progestin shot used as a female contraceptive under the name "DepoProvera." The men got a shot once every 3 months and rubbed on a gel every day, and it worked well at knocking out sperm in 90% of them. However, men's opinions of the method varied widely: 6 dropped out, and of the remaining 38, half of them were satisfied or very satisfied, a third were dissatisfied or very dissatisfied, and the rest were undecided or had mixed feelings.

b) Shepherd Medical Company announced the results of their very first U.S. study in men of the "Intra Vas Device" (a vasectomy alternative): after 6 months, 92% of the men had no sperm or almost no sperm. The Intra Vas Device blocks sperm in the vas deferens, the tube sperm swim through (the same tube that is cut in vasectomy). The set of plugs can be removed if a man changes his mind, so it is much easier to get sperm flowing again than after vasectomy. Animal studies have shown that fertility returns if the IVD is removed after short-term use, but that doesn't guarantee successful pregnancy after long-term use. The next step will be to find funding for long-term studies of effectiveness and fertility return.

c) Columbia University researchers took advantage of the importance of vitamin A to design a new contraceptive approach. Men who are extremely low in vitamin A lose their fertility-- but they also become extremely sick, so avoiding vitamin A doesn't work as a contraceptive. Instead, Professor Debra Wolgemuth discovered a drug that had been abandoned by a pharmaceutical company precisely because it interfered with vitamin A receptors in the testes. Her team tested it in mice, and it worked with no health effects. "The receptors are everywhere, but the testis is exquisitely sensitive to the drug. So we can use a dose that is so low it has no effect on the rest of the body."

So the drug doesn't harm mice-- but will it be fine in men? Dr. Wolgemuth thinks the chances are good. "There's extensive toxicology data in rats and rabbits -- and at much higher doses-- because industry is developing it for other uses. So we're optimistic that there would be no adverse side effects in humans as well."

So how long must we wait? Advocates say it all depends on men speaking up. "We've seen today that the pipeline is full-- everything from new targets to actual human trials," explains Kirsten Thompson, director of the International Male Contraception Coalition. "And the demand is there-- hundreds of men have voiced their opinion on our website MaleContraceptives.org and in surveys. So it's just a question of whether policymakers act on that demand." Elaine Lissner, director of the Male Contraception Information Project, concurs. "We could have something like the IVD on the market in 4-5 years, if we make an all-out effort with funding and focus. But if we continue with just a study here and a study there, it could be an eternity."

- Male Contraception Information Project