Imagine a contraceptive that could, with one or two painless 15-minute non-surgical treatments, provide months of protection from pregnancy. And imagine that the equipment needed were already in physical therapists' offices around the world.

Sound too good to be true? For years, scientists thought so too. But new research headed by Dr. James Tsuruta in the Department of Pediatrics at the University of North Carolina-Chapel Hill, published Monday in the journal Reproductive Biology and Endocrinology, is gaining the contraceptive method increased respect. The kicker: This treatment would be for men - giving them the first new option since condoms and vasectomy were introduced more than a century ago.

HOW IT WORKS

The testes need to be slightly cooler than the rest of the body to properly produce sperm - the subject of countless jokes and warnings about hot tubs, laptops, and tight pants. But although hot tub or laptop use can push a man's sperm count over the edge if he's already low, it's not reliable enough for contraception. What if this heat effect could be enhanced?

That's where ultrasound comes in. Relatively inexpensive and already in use in physical therapists' offices around the world, therapeutic ultrasound (as opposed to diagnostic ultrasound) heats deeply and increases circulation to injured joints. The physical therapist applies lubricating gel to the joint, turns on the machine, and runs the wand back and forth over the joint for 5 or 10 minutes, creating a pleasant warming sensation.

It turns out, though, that ultrasound can be used on other body parts as well. That includes the testes, and it would be for contraception rather than healing. In the current study, researchers got more than 2 1/2 months - and possibly long-lasting - contraception in rats with two 15-minute sessions of ultrasound, two days apart. And their study is the first to provide detailed insight into how ultrasound might be working, using modern equipment. But the published evidence that it works has been in plain sight for more than 35 years- not taken seriously until recently.

OVERLOOKED FOR DECADES

Dr. Mostafa Fahim of the University of Missouri, Columbia was the first to try therapeutic ultrasound for contraception. He and his team showed effect in rats, cats, dogs, monkeys, and even 8 men, publishing journal reports and book chapters in 1975-1982 and patents in 1977 and 1978. But it seemed too strange to be true. Were those effects really reproducible? Other researchers were suspicious enough that a site visit team was even sent to his lab.

Then in 1988 a more respected researcher, Ronald L. Urry of the University of Rochester, dealt what seemed like the death blow for ultrasound as contraception. In trying to repeat Dr. Fahim's experiments, he showed no significant effect on sperm production. Even when he turned it up so high that he saw burns, he still saw little to no effect.

 

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