Testicular therapeutic ultrasound
Note 2014: Based on recent results, it seems harder to get ultrasound to have long-lasting effect in animals with larger testes (humans and large monkeys), despite excellent results in rats and dogs. The trick has not yet been found. However, ultrasound may have potential as a backup contraceptive. See details below.
In 2007, Parsemus Foundation sponsored a study, conducted by Family Health International with the University of North Carolina, to test therapeutic ultrasound applied to the testes as a multi-month contraceptive (reportedly 15 minutes of treatment for about 6 months of effect). This method was shown to work by one professor in the 1970’s but had never been taken seriously by other researchers until now. The FHI/UNC team’s successful pilot study was the basis for the UNC team’s winning application for a Bill & Melinda Gates Foundation Grand Challenges Explorations grant to continue the work. Congratulations to the team for doing the work that got this method taken seriously!
In January 2012, the results from the UNC team were published and got widespread press coverage. Here are a few examples:
Parsemus Foundation is also funding an Italian team working on ultrasound to continue their successful work on ultrasound as permanent sterilization in dogs. The study should be published in late 2014.
Application of ultrasound to dog testes. Photo credit Raffaella Leoci.
Lastly, we have funded an ultrasound study at the University of California, which has managed to get it to have some effect in primates (although not as quick or long-lasting as in dogs; these older monkeys have big tough testes!). Preliminary results from all three teams were presented in October 2011 as posters at the Future of Contraception Initiative conference, and the final monkey results are now published here.
The total number of morphologically normal sperm in an ejaculate (total normal count) from male monkeys treated by two methods of ultrasound exposure. The black arrow indicates the time of ultrasound exposure. From Vandevoort & Tollner, 2012.
It is now clear that under the right conditions, ultrasound works in dogs and rats (and has some effect in monkeys). However, the trick for getting long-lasting effect in large adult monkeys, and humans, has yet to be found. In fact, in late 2013 a first man decided to try ultrasound. He started with a very high personal sperm count, it is true, but it is discouraging that he found the effect of ultrasound wearing off within a few months, despite completing at least 10 treatments of 20-30 minutes on a Monday-Wednesday-Friday schedule. His results were as follows:
|SPERM EVALUATION||Pre-treatment||During treatment||Right after treatment||After treatment|
|Total Sperm Concentration||62,000,000||42,400,000||33,400,000||49,400,000|
|% Normal Morphology||55||30||20||30|
|Total Sperm Count||124,000,000||63,600,000||66,800,000||98,800,000|
Based on the results of these studies, though, we think ultrasound has the most potential as a nonsurgical sterilization alternative for animals, but only a supplemental contraceptive for men, rather than the 6-month contraceptive originally imagined (since with short-term use, one gets into tricky issues of how long it takes to wear off, whether there might be poor-quality sperm during the bounce-back period that are still capable of fertilizing and causing an abnormal offspring, and whether and how reliably fertility would bounce back after repeated use). It might be something men would want to use as a supplement to condoms or as a supplement to their partner’s contraceptive. However, knowing that even fairly short-term use in smaller animals can lead to permanent infertility, it is probably best only for men who want no more children, given that there are so many questions about both how long the action lasts and how well fertility returns, and that changes in regimen can make a big difference in effect.
Other men may experiment with ultrasound, now that the proof of concept has been published in animals and the first man has tried it since Dr. Fahim’s studies in the 1970’s. It is readily available (ultrasound machines are already in physical therapists’ offices around the world). Ultrasound also has great potential as a nonsurgical hormone-sparing sterilization for dogs (a specialty item of interest to owners of large-breed dogs), and a study will be released on this in late 2014. However, Parsemus Foundation must keep its focus on Vasalgel now and will not be funding additional studies.
More about ultrasound can be found at the Male Contraception Information Project.