A novel male contraceptive pill-patch combination: Oral desogestrel and transdermal testosterone in the suppression of spermatogenesis in normal men

This study investigated the effect of transdermal T and oral desogestrel on the reproductive axis of healthy men. Twenty-three men were randomized to 1 of 3 treatment groups and received a daily transdermal T patch plus oral desogestrel at a dose of 75, 150, or 300 mug/d for 24 wk. Baseline blood an d semen samples were obtained and then every 4 wk thereafter for 32 wk. The outcome measures were sperm density and plasma levels of FSH, LH, total an d free T. The results show a dose-dependent suppression of spermatogenesis and gonadotropins. Seven of the 17 subjects became azoospermic: Desogestrel (300 jig daily) in combination with 5 mg daily transdermal T was the most effective (57% azoospermic), whereas a dose of 75 mug was ineffective (0% a zoospermic). Total and free plasma T were reduced by approximately 30%. Hig h density lipoprotein cholesterol was significantly reduced. No serious sid e-effects were encountered. We conclude that daily self-administered desoge strel with transdermal T is capable of suppressing the male reproductive ax is, although the efficacy was less marked and less consistent than injectab le regimens. The lower efficacy is likely to be due to failure of the trans dermal T system to maintain circulating T levels consistently in the requir ed range.