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Review

Applying emerging science to contraception research: implications for the clinic

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Pages 115-126 | Published online: 18 Oct 2014
 

Abstract

Emerging science will make an important contribution towards the development of improved contraceptives. While long-acting reversible contraceptives remain the most effective method, new user-controlled, mid-acting methods will avoid the need for procedures requiring trained providers. Contraceptives combined with other agents may bring additional health benefits, such as dual protection against both pregnancy and sexually transmitted infections. Emerging research areas in proteomics allowed the discovery of new reproductive targets that may lead to non-hormonal contraceptives for both men and women. Current research objectives include the improvement of existing contraceptive methods, as well as discovery of new materials able to deliver new molecules more specifically to their target without systemic actions.

Acknowledgement

The authors are grateful to the agencies and donors including the US Agency for International Development; the National Institute of Child Health and Disease (NICHD) of the National Institute of Health; the World Health Agency, the Bill & Melinda Gates Foundation, the George Hecht and the Hewlett Foundations; UNFPA, as well as Collaborative Agencies and Country Governments who supported the research work of the Population Council

Financial & competing interest disclosure

R Sitruk-Ware is employed by the Population Council, a not-for-profit organization developing new contraceptives, several of which are described in this review and has received a grant from the National Institute of Child and Health Development (NICHD) for which she is the Project Director and Principal Investigator and supporting the research of projects described in this paper. There are no financial benefits linked to this research. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.

Key issues
  • 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.

  • Long-acting reversible contraceptives are the most effective method but need access to trained providers for insertion or removal.

  • User-controlled methods such as vaginal rings and mid-acting methods such as 3-month or 1-year vaginal rings are easy to use and distribute with no need for procedures requiring trained providers.

  • Contraceptives combined with antiretroviral agents to provide dual protection against both pregnancy and STIs are under active search.

  • Other added health benefits of new molecules such as neuro-protective effects of progesterone and similar molecules, or prevention of breast cell proliferation with progesterone receptor modulators, may bring improvement to global health.

  • Pericoital methods to be used on-demand, longer acting injectables, male contraceptive implants, and permanent contraception are also high on the research agenda to offer options for all stages of the reproductive life for women and men.

  • Emerging areas of research on genomics and proteomics allowed the discovery of new targets in the male and female reproductive systems and a few products will reach the clinical stage in this decade.

  • New materials for delivery systems and for targeted delivery of novel molecules to the reproductive tract, without systemic actions, may also become available in the next decade.

  • Improving existing contraceptive methods as well as developing new products easy to use and distribute will increase access to new options for men and women, helping to prevent unwanted pregnancies and abortion and leading to a better quality of reproductive health life.

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