WHAT IT IS: An oral contraceptive that interrupts the monthly cycle of egg release in women, preserving those eggs until later in life (i.e., until after one's career is established).
PROS: In theory, similar to egg freezing but more desirable, since the woman's eggs would sit in her ovaries — rather than a massive cryo-chamber — until she's ready to use them.
CONS: Until further testing is completed, no one knows if the viability of the stored eggs will correspond to the age of the young woman who started taking the medicine decades ago, or the middle-aged woman who's ready to use them. In other words, you can't change the fact the eggs inside a forty-year-old woman are forty years old.
PERSPECTIVE: Perhaps a simpler solution would be to make it easier for mothers to work? The technology remains highly experimental, so debate at this point is somewhat academic.
E.T.A.: At least ten years; according to some, far longer.
promotion
The Male Birth-Control Pill
WHAT IT IS: A pill, injection or implant (or combination thereof) containing the hormones progestin and testosterone. These block sperm production, reduce sperm count to zero, or render sperm tailless so they can't swim to the egg. One treatment being tested in China combines a progesterone pill with a testosterone patch (the "pill-and-patch method").
PROS: A male Pill would give men some power over contraception beyond condoms (which married and long-term couples often abandon), and vasectomies, which are invasive and difficult to reverse.
CONS: Testosterone injections can cause weight gain and acne, and they don't sit well with several internal organs. Protein inhibitors might someday be used to keep sperm from growing tails, but that's science fiction for now.
PERSPECTIVE: The social implications of putting birth control in the hands of those who can't get pregnant have yet to be fully explored. Even if such a pill became available, will women trust men to take it? An under-the-skin implant could take trust out of the equation altogether. Overall, a male Pill could yield a Viagra-like revolution in male sexuality.
E.T.A.: A Dutch company called Organon was expected to deliver a male Pill by this year, but it now looks to be at least five years away. Other studies in Europe and Australia are pending.
The New Vasectomies
WHAT IT IS: Injecting the vas deferens with different chemical solutions, plugging it with a silicone cylinder, or installing battery-powered capsules down there.
PROS: The current vasectomy, a brute-force method of snipping and sealing the vas deferens, is usually performed under local anesthesia and is charitably described as "uncomfortable" by doctors. The new methods are quick, relatively painless and easily reversible.
CONS: Minor though it may be, it's still surgery, and long-term results are unproven.
PERSPECTIVE: The popularity of the vasectomy has declined since its '70s heyday. Still, about half a million American men get the snip done every year. The antiquated procedure needs updating, and some of these concepts look promising. The silicone plug actually isn't as horrifying as it sounds, requiring the tiniest of incisions during a thirty-minute procedure. In India, trials are ongoing for something called RISUG (Reversible Inhibition of Sperm Under Guidance), which involves injecting a honey-like substance into the vas deferens that ruptures the membranes of passing sperm. Products like battery-powered capsules, however, which would emit low-level, sperm-immobilizing electrical currents, sound a bit more Innerspace than necessary.
E.T.A.: Still in trials. Nothing is likely to hit the market for at least five years.
Antifertility Vaccination
WHAT IT IS: An injection that neutralizes a pregnancy hormone in women (HCG) or a sperm-growth hormone in men (FSH).
PROS: Large numbers of people could be vaccinated with relative ease, which could aid in family planning in the developing world more efficiently than condoms, which are often used incorrectly and sporadically. The hormone-based birth-control shot, Depo-Provera, must be taken every three months, but a vaccine could remain effective for years after injection, requiring only occasional booster shots.
CONS: The biological implications of suppressing the human reproductive system could render this technology dead on arrival. Most vaccines have a revving-up phase when first injected and a waning phase as they begin to wear off — not a major concern with a flu shot (when you might be only eighty percent protected during these periods), but quite inconvenient in a contraceptive. Most harrowing: women who do accidentally conceive while on the vaccine may not only end up with an unwanted pregnancy, but a fetus with birth defects or health problems.
PERSPECTIVE: After more than a decade on the market, Depo-Provera — a similar injection with much shorter-term effects — remains controversial. Critics charge that its cost-effectiveness makes poor minorities use it in disproportionate numbers. An antifertility vaccination will be met with the same controversy, only tenfold and on a global scale. Eugenics, mass sterilizations, population control visited upon impoverished nations by first-world pharmaceutical companies — the list of unsettling ethical quandaries is virtually endless.
E.T.A.: The quest for "preventive gynecology" began during the Depression, when birth control was prohibitively expensive for many women. As late as 1993, human trials were still ongoing. But a target date for the approval of such vaccines is nonexistent, perhaps because of its controversial nature.
Cellulose Sulfate
WHAT IT IS: An antimicrobial gel that can be applied to the vaginal wall to help prevent pregnancy and STDs.
PROS: A possible alternative to condoms, especially in cultures where condom use is discouraged.
CONS: The technology remains in the adolescent stage.
PERSPECTIVE: Polydex, a Toronto-based pharmaceutical company, began developing such a product (called Ushercell) in the early '90s. Human clinical trials began six years ago in Africa, and the company reports promising results. People who remember the promise that Nonoxynol-9 could help prevent HIV — and the follow-up warning that it actually made it easier to contract the virus — may be wary of a product that appears to be similar. But human trials indicate that Ushercell does indeed help counteract HIV, as well as prevent pregnancy.
E.T.A.: Phase III human clinical trials got underway last year, but Polydex has not publicly set a target release date.n°
