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Les contraceptions du futur chez l’homme
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ScienceDirect www.sciencedirect.com Annales d’Endocrinologie 75 (2014) 252–257
SFE Lyon 2014
Symposiums SFE夽
SY1-01
Les contraceptions du futur chez l’homme M.C. Meriggiola (Pr) University of Bologna, Bologne Adresse e-mail : [email protected] Although many female contraceptives are available, data on uncontrolled population growth and abortion rate demonstrate that contraceptive choices are still inadequate and accessibility is poor. Broader contraceptive option is an ethical issue that would benefit not only the lives of families and women in particular but would also ensure the survival of our planet. In spite of the shortage of male contraceptives, about 30% of couples rely on a male method and men worldwide show interest in actively contributing to birth control. A variety of approaches has been undertaken in developing a male contraceptive but progress has been poor. The hormonal approach induces profound sperm production through a reversible suppression of gonadotropins and intra-testicular testosterone. In this context, androgen dependent physiological functions must be maintained by exogenous androgen administration. Hormone induced sperm suppression provides optimal pregnancy protection. Androgen-progestin regimens induce profound sperm suppression, and allow spermatogenesis to fully recover to levels consistent with normal male fertility in all men. This approach has many limitations such as the required time until sperm suppression is achieved and until fertility is regained after discontinuing. Even the most effective regimen suppresses spermatogenesis to the threshold useful for contraceptive protection in only about 90% of subjects. A recent multicenter efficacy study supported by CONRAD and the WHO tested the efficacy of the combined administration of eight weekly injections of NETE 200 mg and TU 1000 mg. The trial has been prematurely terminated due to mood-related side effects despite results show good sperm suppression and contraceptive protection. Déclaration d’intérêts d’intérêts.
L’auteur n’a pas transmis de déclaration de conflits
http://dx.doi.org/10.1016/j.ando.2014.07.011 SY1-02
Les modulateurs du récepteur des progestatifs (SPRM) ; une nouvelle contraception ? N. Chabbert-Buffet (Pr) Service de Gynécologie Obstétrique Médecine de la Reproduction, Hôpitaux Universitaires Paris Est-site Tenon, Université P et M Curie, AP–HP, Paris, France Adresse e-mail : [email protected]
夽 Résumés présentés lors du 31e Congrès de la Société franc ¸ aise d’Endocrinologie Lyon 2014.
http://dx.doi.org/10.1016/j.ando.2014.07.010 0003-4266/
Les modulateurs sélectifs du récepteur de la progestérone (SPRMs) actuellement commercialisés sont des dérivés stéroïdiens exerc¸ant une activité anti-progestative variable. Les SPRMs peuvent avoir une action contraceptive par différents mécanismes le blocage de l’ovulation et un effet endométrial propre. L’anovulation dans ce contexte n’entraîne pas de carence estrogénique. Les applications gynécologiques actuelles sont la contraception d’urgence et le traitement des fibromes hémorragiques. La tolérance gynécologique et systémique est bonne. Les SPRMs ont également été évalués en association aux microprogestatifs pour améliorer le profil de saignement. Les voies de recherche actuelles incluent la meilleure compréhension du mécanisme d’action anti-ovulatoire, l’évaluation des effets endométriaux à long terme, la recherche de nouvelles galéniques (dispositifs intra-utérins, anneaux vaginaux). Déclaration d’intérêts L’auteur n’a pas transmis de déclaration de conflits d’intérêts. Pour en savoir plus Donnez J, et al. Ulipristal acetate versus leuprolide acetate for uterine fibroids. N Engl J Med 2012;366:421–32. Chabbert-Buffet N, Pintiaux A, Bouchard P. The immninent dawn of SPRMs in obstetrics and gynecology. Mol Cell Endocrinol 2012;358:232–43. Glasier AF, et al. Ulipristal acetate versus levonorgestrel for emergency contraception: a randomised non-inferiority trial and meta-analysis. Lancet 2010;375(9714):555–62. http://dx.doi.org/10.1016/j.ando.2014.07.012 SY1-03
Les contraceptions du futur chez la femme R. Sitruk-Ware (Pr) Population Council, New-York Adresse e-mail : [email protected] Although a steady increase in contraceptive use has been observed over the past decades, the contraceptive needs of a significant percent of couples have not yet been met. Emerging scientific opportunities may shape the future scientific agenda in reproductive research in the context of new and advanced technologies for the development of improved contraceptives. While long-acting methods, such as implants and IUDs seem preferable for women with compliance issues, mid-acting user-controlled methods such as 1-year vaginal rings proved effective and well accepted by women. Transdermal gels or sprays used daily have shown high acceptability as the methods can be used privately. Progesterone receptor modulators (PRMs) block ovulation and induce amenorrhea. In the future, contraceptives may be combined with other medicinal agents to provide dual protection against both pregnancy and another preventable condition, such as sexually transmitted infections. Also, the neuroprotective effects of progesterone and similar molecules are new areas of research supporting the development of novel contraceptives with added health benefits. Emerging areas of research, such as genomics and proteomics created a new scientific opportunity. New areas of basic research include studies on genes, proteins and
ScienceDirect www.sciencedirect.com Annales d’Endocrinologie 75 (2014) 252–257
SFE Lyon 2014
Symposiums SFE夽
SY1-01
Les contraceptions du futur chez l’homme M.C. Meriggiola (Pr) University of Bologna, Bologne Adresse e-mail : [email protected] Although many female contraceptives are available, data on uncontrolled population growth and abortion rate demonstrate that contraceptive choices are still inadequate and accessibility is poor. Broader contraceptive option is an ethical issue that would benefit not only the lives of families and women in particular but would also ensure the survival of our planet. In spite of the shortage of male contraceptives, about 30% of couples rely on a male method and men worldwide show interest in actively contributing to birth control. A variety of approaches has been undertaken in developing a male contraceptive but progress has been poor. The hormonal approach induces profound sperm production through a reversible suppression of gonadotropins and intra-testicular testosterone. In this context, androgen dependent physiological functions must be maintained by exogenous androgen administration. Hormone induced sperm suppression provides optimal pregnancy protection. Androgen-progestin regimens induce profound sperm suppression, and allow spermatogenesis to fully recover to levels consistent with normal male fertility in all men. This approach has many limitations such as the required time until sperm suppression is achieved and until fertility is regained after discontinuing. Even the most effective regimen suppresses spermatogenesis to the threshold useful for contraceptive protection in only about 90% of subjects. A recent multicenter efficacy study supported by CONRAD and the WHO tested the efficacy of the combined administration of eight weekly injections of NETE 200 mg and TU 1000 mg. The trial has been prematurely terminated due to mood-related side effects despite results show good sperm suppression and contraceptive protection. Déclaration d’intérêts d’intérêts.
L’auteur n’a pas transmis de déclaration de conflits
http://dx.doi.org/10.1016/j.ando.2014.07.011 SY1-02
Les modulateurs du récepteur des progestatifs (SPRM) ; une nouvelle contraception ? N. Chabbert-Buffet (Pr) Service de Gynécologie Obstétrique Médecine de la Reproduction, Hôpitaux Universitaires Paris Est-site Tenon, Université P et M Curie, AP–HP, Paris, France Adresse e-mail : [email protected]
夽 Résumés présentés lors du 31e Congrès de la Société franc ¸ aise d’Endocrinologie Lyon 2014.
http://dx.doi.org/10.1016/j.ando.2014.07.010 0003-4266/
Les modulateurs sélectifs du récepteur de la progestérone (SPRMs) actuellement commercialisés sont des dérivés stéroïdiens exerc¸ant une activité anti-progestative variable. Les SPRMs peuvent avoir une action contraceptive par différents mécanismes le blocage de l’ovulation et un effet endométrial propre. L’anovulation dans ce contexte n’entraîne pas de carence estrogénique. Les applications gynécologiques actuelles sont la contraception d’urgence et le traitement des fibromes hémorragiques. La tolérance gynécologique et systémique est bonne. Les SPRMs ont également été évalués en association aux microprogestatifs pour améliorer le profil de saignement. Les voies de recherche actuelles incluent la meilleure compréhension du mécanisme d’action anti-ovulatoire, l’évaluation des effets endométriaux à long terme, la recherche de nouvelles galéniques (dispositifs intra-utérins, anneaux vaginaux). Déclaration d’intérêts L’auteur n’a pas transmis de déclaration de conflits d’intérêts. Pour en savoir plus Donnez J, et al. Ulipristal acetate versus leuprolide acetate for uterine fibroids. N Engl J Med 2012;366:421–32. Chabbert-Buffet N, Pintiaux A, Bouchard P. The immninent dawn of SPRMs in obstetrics and gynecology. Mol Cell Endocrinol 2012;358:232–43. Glasier AF, et al. Ulipristal acetate versus levonorgestrel for emergency contraception: a randomised non-inferiority trial and meta-analysis. Lancet 2010;375(9714):555–62. http://dx.doi.org/10.1016/j.ando.2014.07.012 SY1-03
Les contraceptions du futur chez la femme R. Sitruk-Ware (Pr) Population Council, New-York Adresse e-mail : [email protected] Although a steady increase in contraceptive use has been observed over the past decades, the contraceptive needs of a significant percent of couples have not yet been met. Emerging scientific opportunities may shape the future scientific agenda in reproductive research in the context of new and advanced technologies for the development of improved contraceptives. While long-acting methods, such as implants and IUDs seem preferable for women with compliance issues, mid-acting user-controlled methods such as 1-year vaginal rings proved effective and well accepted by women. Transdermal gels or sprays used daily have shown high acceptability as the methods can be used privately. Progesterone receptor modulators (PRMs) block ovulation and induce amenorrhea. In the future, contraceptives may be combined with other medicinal agents to provide dual protection against both pregnancy and another preventable condition, such as sexually transmitted infections. Also, the neuroprotective effects of progesterone and similar molecules are new areas of research supporting the development of novel contraceptives with added health benefits. Emerging areas of research, such as genomics and proteomics created a new scientific opportunity. New areas of basic research include studies on genes, proteins and