Why Male Contraception: Dr. John Amory
The world’s population exceeds seven billion, is increasing by 80 million yearly and will likely reach 9-10 billion by 2050 (1). Population growth is a leading cause of environmental degradation and human suffering from poverty and hunger (2). Much of this population growth is unintended. In 2008, 41% of all pregnancies worldwide were unplanned, and 20% of all pregnancies ended in abortion, leading to 47,000 maternal deaths from unsafe abortions (3, 4). In the United States, the unintended pregnancy rate is 48%, and 18% of all pregnancies end in abortion, accounting for 1.1 million abortions annually (3).
This high rate of unintended pregnancy is due to inadequate use of and/or access to methods of contraception. Access to contraception dramatically reduces population growth and abortion rates, resulting in positive improvements in newborn and maternal health (5). In addition to the attenuation in world population growth, the use of modern contraception and better maternity care worldwide has the potential to avert 1.7 million newborn deaths and 251,000 maternal deaths each year (5). Therefore, there is a great need for better access to existing contraceptives, better contraceptive education, and more contraceptive options both in the United States and around the world.
In the United States, 30% of all currently practiced contraception is male-directed with 20% of all couples using condoms and 10% of couples relying on vasectomy (6). Both of these methods of male contraception have significant drawbacks. Condoms, while providing some protection against sexually transmitted infections, have a marginal contraceptive efficacy (7), and vasectomy, which is expensive and difficult to effectively reverse, is most appropriately considered an irreversible method of male contraception (8). A reversible male contraceptive would be welcomed by a large majority of men (9, 10), and would have a marked benefit on reducing the rate of unintended pregnancy, unintended population growth and their effects.