Despite significant advances in contraceptive options for women over the last 50 yr, world population continues to grow rapidly. Scientists and activists alike point to the devastating environmental impacts that population pressures have caused, including global warming from the developed world and hunger and disease in less developed areas. Moreover, almost half of all pregnancies are still unwanted or unplanned. Clearly, there is a need for expanded, reversible, contraceptive options. Multicultural surveys demonstrate the willingness of men to participate in contraception and their female partners to trust them to do so. Notwithstanding their paucity of options, male methods including vasectomy and condoms account for almost one third of contraceptive use in the United States and other countries. Recent international clinical research efforts have demonstrated high efficacy rates (90-95%) for hormonally based male contraceptives. Current barriers to expanded use include limited delivery methods and perceived regulatory obstacles, which stymie introduction to the marketplace. However, advances in oral and injectable androgen delivery are cause for optimism that these hurdles may be overcome. Nonhormonal methods, such as compounds that target sperm motility, are attractive in their theoretical promise of specificity for the reproductive tract. Gene and protein array technologies continue to identify potential targets for this approach. Such nonhormonal agents will likely reach clinical trials in the near future. Great strides have been made in understanding male reproductive physiology; the combined efforts of scientists, clinicians, industry and governmental funding agencies could make an effective, reversible, male contraceptive an option for family planning over the next decade.

中文翻译：

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男性避孕的进展。

尽管在过去 50 年中，女性避孕方法取得了重大进展，但世界人口仍在继续快速增长。科学家和活动家都指出人口压力造成的破坏性环境影响，包括发达国家的全球变暖以及欠发达地区的饥饿和疾病。此外，几乎一半的怀孕仍然是意外或计划外的。显然，需要扩大、可逆的避孕选择。多元文化调查表明男性愿意参与避孕，而他们的女性伴侣相信他们会这样做。尽管他们的选择很少，但在美国和其他国家，包括输精管切除术和避孕套在内的男性避孕方法占避孕药具使用的近三分之一。最近的国际临床研究工作表明，基于激素的男性避孕药有很高的有效率 (90-95%)。当前扩大使用的障碍包括有限的交付方法和感知的监管障碍，这阻碍了进入市场。然而，口服和注射雄激素给药的进步令人乐观地认为这些障碍可能会被克服。非激素方法，例如针对精子活力的化合物，在其对生殖道特异性的理论承诺方面很有吸引力。基因和蛋白质阵列技术继续确定这种方法的潜在目标。这种非激素药物很可能在不久的将来进入临床试验阶段。在理解男性生殖生理学方面取得了长足的进步；科学家、临床医生的共同努力，