The Revolutionary Birth Control Method for Men | Hacker News Reader

The Revolutionary Birth Control Method for Men

wired.com

280 pointsspottiness157 comments

Wow. The entire premise of the article aside, for me the idea that medical treatments can be made with physics and not medicine was an incredible, incredible revelation.

This man (not a doctor!) has invented a method to neutralize sperm in a way that would never have occurred to me. He uses the most basic principles of physics (magnetic charge) to neutralize sperm!

Realizing that sperm is negatively charging, he simply coats a short section of the inside of the vas (tiny tube going from testes to the penis, located in the scrotum) with a positively-charged polymer. As sperm travels in this coated tube, the ionic attraction causes damage on a cellular level in the sperm, the pull effect effectively destroying the sperm "tail" and preventing it from fertilizing a female but without hormonal/medical methods!

For me, as an engineer, this was a true revelation.

As a physicist, I have been, on odd occasions of boredom and quarter-life-crisis, tempted to go into medicine. But the only type of medicine I'd be interested in is radiology.

Walk in, cure a patient with physics, walk out, earn $600K a year. Sounds pretty sweet!

What's that? You have cancer? No worries, I have radioactive beams! Zap! You're cured!

Unfortunately you gotta go through many years of the more usual, squishy form of medicine before they'll let you become a radiologist, so I stuck with my existing career path.

I knew a radiation oncologist in the late 90s, and his reason for becoming a webapp startup founder instead was that radiology was destroying him: in that field, most of your patients die, rather than being cured. You're mostly just prolonging things.

I see. And this is really frustrating unless you change the mindset to take everyday that is gained as a little victory for patients to enjoy life. But for patients of terminal cancers, the quality of life only deteriorates.

Having seen both my parents suffered terminal cancers and passed away, I think any economical way that can make people living to the end without losing quality of life is more important than prolonging life. And IMHO that is a very tough problem to work on.

All patients die. The job of a specialist is to make sure they die of something else.

Am I missing something, or does the article in no way explain what is charged and how?

magnetic charge? really? I don't think so.

In its report, the WHO team agreed that the concept of RISUG was intriguing. But they found fault with the homegrown production methods: Guha and his staff made the concoction themselves in his lab, and the WHO delegation found his facilities wanting by modern pharmaceutical manufacturing standards. Furthermore, they found that Guha’s studies did not meet “international regulatory requirements” for new drug approval—certain data was missing. The final recommendation: WHO should pass on RISUG.

Is this an example of why health care is so incredibly expensive in this country?

Do these "modern pharmaceutical manufacturing standards" actually buy us extra safety?

I'm sure it's not as black and white as that. There's a certain level of safety requirements, and we could probably relax them with only a small percentage of people suffering or dying as a result. We could also raise them, and decrease that number. Etc, etc., it's all a numbers game, and I'm already boring myself with this argument.

  Do these "modern pharmaceutical manufacturing standards"
  actually buy us extra safety?

Yes, but we pay a price:

* Evaluations take a really long time. So it's hard to get the drugs into the hands of people.

* Development is now extremely expensive. That forces just about everyone except the largest drug mega-corporations out of the market.

* Drugs that would be a net benefit to the world sometimes never make it through the entire process because the ROI isn't good enough, or the associated side effects are deemed too harsh. (We would likely not have aspirin today if it hadn't been developed prior to the modern way of drug development... it has too many high-risk side effects)

On the plus side:

* The drugs you do get are generally far safer and better understood than they otherwise would be

* You can feel safe that each batch of the drug was made the same way, using the same process, and ends up having the same strength/effectiveness as every other batch of the same drug... even when made by a different company. (We take that for granted now... but it's actually a really big deal if you look at medication from a historical perspective.)

* We have far fewer snake-oil salesmen ripping people off for cures that are, at best, useless and at worst, cause the condition to get worse, or cause birth defects, or some other harm. If we do find the drug doing harm, it gets pulled off the market

"We also have far fewer snake-oil salesmen ripping people off for cures"

Yet we still have chiropractors and homeopathy.

Sadly, they get around all the regulation by not making specific medical claims. If they did, then regulation would come down on them like a ton of bricks (as it did to producers of Cherries at one point). It's the difference between saying "Product X will cure Y" (illegal unless it's gone through all the testing) and "Product X may promote health" (which is entirely legal). It doesn't make much sense.

Hold on - Chiropractors are in the same class as homeopathy? I thought Chiropractors (which, admittedly, I've never been to, but have heard many good things about - particularly when people need to get their back "adjusted") were in the same class as Acupuncturists - kind of easternish philosophy, but effective within their domain. Not so much focussed on increasing health, as enhancing comfort (or reducing pain) without drugs.

Not the case?

I would like to know the real answer on this, too. I have read from people who claim to have been on the industry's inside (went to school for it, etc). The claim is that there are a bunch of logical steps based on false premises/beliefs and that some of the work results in mid- to long-term damage to the body in exchange for short-term relief.

Edit: http://www.chirobase.org/05RB/CPSQ/02.html -- More information that looks like something I have read.

Edit2: http://www.chirobase.org/01General/controversy.html -- "NACM members publicly renounce the subluxation theory and other forms of chiropractic pseudomedicine." Interesting stuff. What I read: There is a portion of "chiropractic medicine" that is snake oil; how do I identify what is real? Are NACM members better informed?

I've been to a chiropractor before and it really does work, at least for the problem I was experiencing (which was some sort of simple alignment problem.) The guy basically just pushed on my spinal column in different directions and I could clearly feel things moving back into place. I definitely would not lump them in with the quackery that is homeopathy, as long as you stay within the bounds of "pushing bones into alignment" and stay away from things like "improve the chi flow throughout your chakra nodes" or some such nonsense.

Until you realize that your bones were 'out of alignment' because you have weak core muscles that you should build up instead. In fact, 'pushing spinal column bones into alignment' without any x-rays or further inspection sounds pretty dangerous to me. What if the chiropractor pushes it too far and strains something, causing me to return for another adjustment? Everyone I know who has tried a chiropractor ends up going back over and over again, like an addiction.

Meanwhile, I had some back pain and started doing pilates and it evaporated, because now my core can actually hold my backbone up.

/plural of anecdote is not data

I've seen a chiropractor and x-rays are a part of the procedure. You can't do medicine without seeing that there is a problem, correcting the problem, and then verifying that the problem is solved.

You can't do medicine without seeing that there is a problem, correcting the problem, and then verifying that the problem is solved.

No one is debating that. What we're debating is whether chiropractic is medicine.

If chiropracty works, it would be a surprise given the history. See http://en.wikipedia.org/wiki/Chiropractic_history for more details, but basically it was founded by a complete crackpot and there's no reason to believe it should work.

Further, many studies have found weak effects, no effects, and negative effects. When you see this kind of evidential pattern, it almost always means that the effect isn't real and we're just seeing experimental error. See http://en.wikipedia.org/wiki/Chiropractic#Evidential_basis

That said, the placebo effect for something like chiropracty or massage can be very strong - and the placebo effect is real! Giving someone a saline shot creates a stronger effect than giving them a sugar pill; I don't know where chiropracty exists on that spectrum.

Off topic -- Where is the 'Edit' button on http://en.wikipedia.org/wiki/Chiropractic#Evidential_basis ?

The article doesn't say it's locked, but I see no edit button.

I was trying to replace "Opinions differ as to the efficacy of chiropractic treatment" with "Opinions differ as to the ability of chiropractic treatment to produce an effect", because I have a grudge against overly complicated language.

What's already there is better. :(

Also, if you look to the top right corner of the page, there's a lock icon that shows the article is semi-protected. You can't edit it without logging in.

Why is replacing one word with 4 making it less complicated?

Because more people will understand the longer version than the shorter one. A wiki is not a computer program.

http://simple.wikipedia.org

My own anecdotal experience would leave me surprised if controlled studies found that modern chiropractic care had no useful effect at all. Over a three month period I watched one guy go from a hunch-backed nerdy appearance to a shoulders-back, upright, and confident posture. Chiropractors probably can't cure ulcers, but they probably can accelerate improvements in posture, which have payoffs in other areas (improved posture->reduced pain->less stress caused by pain->better quality of life).

PBS did a report on alternative medicine, including Chiropractic. They didn't have much good to say:

http://www.ncahf.org/news/saf.html

I agree they are in the same class with acupuncturists, in the "stuff that doesn't work"-class.

Actually the best current evidence is that acupuncture does bring real pain relief: http://www.umm.edu/news/releases/back_pain.htm

That said, most of its relieving effect is due to the placebo effect, and there is no evidence saying that it can do anything for you other than possibly reduce pain.

"The sham acupuncture studies were double-blinded, meaning neither the researchers nor the participants knew who was receiving the real or the sham treatment. When looking at those studies, the reviewers found the differences in pain ratings showed a significant difference between the real acupuncture and the sham acupuncture groups, indicating that the benefit was not just due to the placebo effect."

How did you get "most of its relieving effect is due to the placebo effect" from the article?

I concluded that from several articles that I read on the way to picking that was as best representing current thought on the effectiveness of acupuncture.

There is still debate on whether real or fake acupuncture is better. (Studies have come down on both sides of this issue.) However pretty much everyone who has tried to study the subject has found that both real and fake acupuncture have a definite impact on pain. Frequently both will outperform conventional medicine. For a random example see http://featuresblogs.chicagotribune.com/features_julieshealt....

From that I know that there is a readily measurable benefit to acupuncture, another readily measurable benefit to the placebo, and the difference between the two benefits is difficult to measure. Which leads me to conclude that most of the benefit from acupuncture is due to the placebo effect, and only (possibly) a little is because acupuncture itself is effective.

Two weeks ago I went to see a chiropractor. I was in so much pain I could barely walk, and my lower back wouldn't flex enough for me to stand up straight. She thought I probably had a pulled muscle. She stretched my legs and hips, twisted my spine a bit and showed me some stretches that I could do at home. I left feeling a bit sore, but otherwise fine. It took 20 minutes and cost me $60.

It might not be medicine, but it's not snake-oil either.

Like almost everything, testing suffers from diminishing returns. The difference between no testing and delta testing is often huge, but the difference between a lot and a lot plus delta is often pretty small. But each delta of testing you add costs the same amount in terms of the prices you listed.

The optimal thing to do would be to keep adding more testing until the benefits of the latest delta drop to equal their costs. However, all the economic research on this topic that I've read suggests that while we need some testing we're way over the optimal point. Its the same sort of research that lets you publish papers on how the optimal copyright length is 14 years.

The same sort of ratchet effects are involved in both places too. The only people who care passionately about copyright lengths are those who have copyrights that are about to expire. The people who could have benefited from a work going out of copyright are often only dimly aware of it. Likewise when the FDA approves a drug that causes problems its obvious and there are a lot of people complaining, but when they don't approve a drug that could have helped someone - or when drug developers are scared off - people aren't as aware of it.

This is presented as though it's an instance of regulatory capture - which it may be - but I don't think we really have enough information to draw that conclusion.

It's entirely possible that there was concern for contamination or the like in the methods used, which would be a fair concern. On the other hand, the current manufacturing methods don't strike me as sufficient reasoning to pass on the concept as a whole, if that's indeed what the final recommendation means, as the article seems to imply.

It's difficult to assess the situation without having the WHO report or an inspection.

The long and short of it is YES. There are regulations regarding the quality and reproducibility of pharmaceutical manufacturing processes (the CMC - chemistry, manufacturing and controls portion of an IND/NDA) that go a long way to ensure the safety of patients here in the US. Yes, they can be expensive to comply with. But current Good Manufacturing Process (cGMP) regulations are a necessary component to not only protect patients, but also to ensure the validity of the clinical data collected. Without these controls, changes in formulation, lack of reproducible drug substance (Active pharmaceutical ingredients, or APIs), and finished drug products (including container-closure systems), there is no way to be sure what the patient is getting is equivalent to what was used to obtain approval (NDA/BLA/PMA/510k) or consistent across the marketplace. There was a big push to get manufacturing and studies done "on the cheap" in India, China, SouthAmerica, and Eastern Europe. But over the past few years, many companies have pulled back development in these areas (unless they were planning to launch products in these regions) due to lack of oversight and poor quality of production and study conduct at clinical sites. And rightly so. If the WHO conducted a thorough audit of his processes and found that they weren't up to par with the FDA or EMA(Europe's FDA) then we should all hope that any development in the US or Europe be conducted in accordance with OUR guidelines and regulations. The India trials could (and should) be used as a benchmark and built upon, but not relied upon out of hand without more diligence and reproducible results across multiple clinical studies (and in various ethnic populations, age groups, and other factors). The inventor has a duty to obtain results using the most controlled and reproducible manner possible. For all of our sakes.

My thoughts exactly. All the objections seem to sidestep the revolution that this drug could be. If the science is there, but some more studies are needed, why didn't the WHO back better lab conditions and make a go for it?

Either they thought it was not a viable theory for a drug, or they were avoiding it for profit/political reasons.

This process may be a preferable alternative to condoms, but it does not stop the spread of STDs. From the WHOs perspective there's no obvious benefit.

I suspect this may be the real cause of their lack of interest.

  > Do these "modern pharmaceutical manufacturing standards" actually buy us
  > extra safety?

They certainly buy us jobs for bureaucrats. Recently the FDA confiscated all of the birthing pools (related to the surge in popularity of water births). Apparently inflatable pools should be classified as 'medical devices.' To quote the FDA, "pregnacy is an illness and birth is a medical procedure."

Do you have a source for that quote?

* http://blog.cuntastic.org/2011/05/26/birth-pools-seized-by-f...

* http://blog.cuntastic.org/2011/05/27/interview-with-barbara-...

Regulation costs account for 90% of bringing a drug to market, on average $1 billion and 10 years of clinical trials for each new drug [1]. Of course, a mere 10 years of clinical trial cannot catch all long-term side effects, and we would be safer if the FDA was more stringent. The flip side is that we would have fewer and more expensive health care options. For better or worse, our regulatory structure is heavily biased towards fewer deaths from approved treatments, very long clinical trials, and expensive health care.

In general, the word "agile" and the health industry have nothing to do with each other.

[1] yeah, yeah, citation needed. I pick facts up by listening to The Economist podcast on the way home, you go find a hyperlink.

The world has been promising male birth control for decades now and the techniques (There are several that all work at almost 100% and are fully reversible) are proven (numerous long term trials, I can think of two from a decade ago off the top of my head, one in Washington state and one in Australia, in their final stages, with fewer side-effects, complications and failures than female birth control) and much more effective than female birth control (100% in most cases). I've been reading about it actively since I was 15 and now I'm 30 and I'm still reading about how it's 5 years away. I want this so bad it hurts, but no one is bringing it to market.

The problem is there isn't (enough of?) an incentive to actually put out these treatments. I guess the money just doesn't compare to female birth control.

If enough people want it, and they will, there is incentive.

But apparently not enough to bring it to market. This is just another example of a male birth control that won't even make it to clinical trials in the G8 nations for another two decades at a minimum.

Are people just that much more skittish about messing with male birth control that it needs 10x the evidence of female birth control before it comes to market, or have government agencies just gotten that much more strict/paranoid?

The problem is there isn't (enough of?) an incentive to actually put out these treatments. I guess the money just doesn't compare to female birth control

One issue is that public health authorities are (probably quite legitimately) concerned that improved male birth control methods will lead to a decrease in the use of condoms and an increase in STDs.

Aside from the STD issue, a condom is a contraception method that is instantly verifiable. "It's okay baby, I have had the invisible sperm destroying procedure" is a bit harder to check.

Why are women on the pill any more trust worthy? I've known women who say they're on the pill just because they didn't wanna use/buy condoms. Surprise, surprise I now know people that have kids that probably shouldn't.

Also, condom misuse is a big problem in general and is the cause of the low rate of success for condoms 85% vs proper use 98%. The people that need condoms the most (uneducated/young people) are the ones that just throw them on without making sure they know how to properly use them.

What is "proper" condom use?

Honest question, as I pretty much just roll a condom on... Is there more to it?

You didn't get the banana demonstration in high school?

For instance, If you don't leave a reservoir at the tip, it increases the possibility that the condom will break.

There's that tiny reservoir at the tip of the rubber already just for that: you really have to work hard to pull it so tight that the reservoir itself gets stretched all over the tip of your penis.

Yeah, well, you'd be amazed at the mistakes people will make without proper instruction.

The bigger problem is that it can capture air as the condom is being put on. The pressure from that captured air increases the risk of breakage. Ergo, 'proper' application involves pinching the reservoir tip as the condom is being rolled on.

Well, one other tip would be - hold it on when you ahem pull out. You don't want any spillage.

Also, make sure you use the right size. If it's too tight or too loose - increased risk of breakage or leakage.

Ok, now I'm a bit weirded out by myself. I'm a woman, so I guess I'm deeply invested in proper condom usage.

Deeply invested indeed. Just make sure you've got a clean exit strategy though!

Adding to other comments. Make sure it didn't break. You can try blowing air inside to see. If it broke use an emergency contraceptive.

I'd be a lot more on board with this suggestion if it didn't involve... blowing into a used condom.

Yeah. As far as I'm concerned, kids should be taught to always use two redundant forms of birth control. No one form of (temporary) birth control has (afaik) higher than 98% success rate even when used perfectly.

It's worth noting what those percentages mean. They report percentages that mean that 1-n% of couples who use it as their sole birth control method for a year get pregnant. So 98% doesn't mean you get pregnant 1/50 times.

98% still isn't great (if you think about it, it means you're fairly likely to have 1 unwanted pregnancy in your life if you always use a 98% effective method), but it's a lot better than how it sounds to people who don't know what those percentages mean.

Really? Well, crap. I wish I'd known that years ago, it would have saved me a whole bunch of worrying.

Wow, these women are the height of irresponsibility.

Here's my theory about why people think that women are more responsible for birth control.

1. They are more directly affected by pregnancy. They are the ones who would have to bear the child or to have an abortion. Abortions are not fun. Vacuuming your uterus is probably not a pleasant experience. Of course, I'm being somewhat flippant. I do think that women who have foresight and intelligence are responsible human beings who try to have children only when they want to. Of course, there are cultural and socioeconomic issues at play here. I"m not trying to suggest that men are not affected by children, but they don't need to bear the physical consequences. So birth control is more of an abstract conception for men. Although they bear the financial consequences...sometimes.

2. The idea that women are more responsible in general. Of course, this is a terrible and misguided stereotype. I know many irresponsible women (One similar to your story - she has two kids now.)If women seem more responsible, it's probably because society teaches women to be responsible and risk-averse from birth.

EDIT: for grammar and formatting.

The height of irresponsibility here is women who claim to be on the pill because they actually want kids, but to afford that they have to "oops" some guy who doesn't. This, and paternity fraud, are what make male birth control important.

Check the scars. Perhaps a photo ID card certifying your procedure is in order. What a way to pick up chicks!

Maybe, but that's a social issue not an FDA (in the US) issue, it shouldn't (ideally) hold up approval. (But it will.)

Every time male birth control is brought up all these same (social) issues get touted about. Women won't trust guys that say they're on the "pill", STDs will become rampant, etc. But they are by no means unique, every new treatment(in a new area) has social issues to begin with, but they usually turn out to be overblown once it becomes accepted.

Holding back progress in one area as leverage to try and force it in another is nearly always a bad way to go. STD's and unwanted children are both problems. If we can fix one of those we should absolutely do it.

Exactly.

Looks like the future of space, medicine, and technology belongs to the countries that have not yet hobbled themselves with lawyers and bureaucrats to the point that something must be perfect if it is to exist at all.

Totally agree. If they continue without all the lawyers they will be far more advanced in 20 years.

If this or some offshoot ever makes it to the US, we should see a dramatic decrease in family law, Federal subsides for child support, and could lead to dramatic decrease in crime. That is, if it becomes as available as womens birth control.

You are making a huge leap from "this is an effective method of birth control" to "people will use this". See the movie Idiocracy. (actually just see the opening bit.)

Idiocracy isn't exactly based on fact. (It's an OK movie though.) For one thing, there's no evidence, that I know of, that supports the claim that only "smart" parents have smart children, or that smart parents don't have dumb children, or that dumb parents don't have smart children, and so on.

Although genetics likely plays some role in "natural" intelligence, it's far from a simple hereditary relationship, and there's increasing evidence that the bulk of natural intelligence is actually the result of environmental factors during early child development.

Did the movie really contain genetic claims? I took the sequence at the beginning to be more a criticism of Cleavon's cultural traits. (example: "I thought you was on the pill or some shit!") In fact, most of the movie's humor centered around a downward cultural slide. Kids do pick up their parents memes more readily, after all.

Yes. IIRC, the "opening bit" that camiller was referencing above was about how intelligent people were continually having fewer children while less intelligent people bred as quickly as they could.

(ninja edit: here ya go: http://www.youtube.com/watch?v=PSROlfR7WTo)

Ok, but isn't that difference in birthdate orthogonal to whether the "intelligence" is a result of nature or nurture? (Don't forget that when you have children you're not just propagating genes, but memes as well. Kids raised on Jersey Shore will tune in to Ow, My Balls!)

I don't recall the movie taking a stance towards nature. In fact, the moral of the whole story is to try to solve problems, and the great speech at the end envisioned a time where people cared whose ass it was and why it was farting. These are messages about cultural priorities, not genetic limitations.

> Don't forget that when you have children you're not just propagating genes, but memes as well. Kids raised on Jersey Shore will tune in to Ow, My Balls!

...right, which would make it irrelevant whether high-IQ parents are having kids or not (they can still work as educators, scientists, leaders -- much the same situation as now), which in turn would make that opening scene of the movie a non-sequitur.

> These are messages about cultural priorities, not genetic limitations.

Yes, but they are also the only feasible remaining strategy left given the resources at hand at the end. IIRC, the lead character was tested as having the highest recorded IQ in the world, so it's not like his strategy for solving problems could be "go find high IQ couples and mate them in a high-IQ zoo".

Maybe I'm wrong. I only watched it once, back at a time when I thought the world was doomed and the movie was prophetic (so I didn't really pay close attention). OTOH, a quick search online finds that I'm not the only one that interpreted it this way, so at the least it was less clear than it could have been on this point.

(they can still work as educators, scientists, leaders -- much the same situation as now)

I don't think working as an educator or leader, in the movie's world, would make any difference. They would be, after all, attempting to educate or lead people who equate speaking in grammatical, semantically precise sentences with "talking like a fag". (see Dr. Lexus, etc.)

As for Scientists, they were consumed with solving the problems of hair loss and prolonging erections.

...that supports the claim that only "smart" parents have smart children, or that smart parents don't have dumb children, or that dumb parents don't have smart children, and so on.

That would be a silly claim to make. A more plausible claim, and one which is well supported by the evidence, is that smart parents are considerably more likely to have smart children than dumb parents.

http://en.wikipedia.org/wiki/Heritability_of_IQ

It sounds like you misunderstand how evolution works.

> If this or some offshoot ever makes it to the US, we should see a dramatic decrease in family law, Federal subsides for child support, and could lead to dramatic decrease in crime. That is, if it becomes as available as womens birth control.

Nope.

Just as with vasectomies, we'll see far more men claiming to have had the procedure and women will believe them.

Yes, a few men who wouldn't have gotten a vasectomy will do this, but they're in the noise.

And add to that a rapidly increasing average age.

For those who aren't interested in seeing a picture of a scrotum being operated on, the technique described is a polymer that is injected into the vas deferens. As sperm pass the polymer, their membranes and tails are damaged. The technique can be reversed using a solvent.

So that means that once you have the procedure done on you, you don't have to do anything (no regular medicine) until you want it reversed?

Yes.

Sign me up!

I have 3 kids and the existing methods available for ensuring we don't have a 4th are, at best, inconvenient. (Condoms are annoying; the pill messes with my wife's emotions; and either of us getting snipped seems scarily irreversible.)

I'll be keeping an eye open for trials here in the US and on any more news about this procedure trickling out from India.

hooray for science!

Plus vasectomy sounds scary painful and potentially dangerous. I'm done having kids but I don't wanna get snipped. Granulomas? In MY testicles? It's more likely than I think.

Vasectomy isn't that bad. The procedure is moderately unpleasant but short (20-30 minutes), and the recovery is a few days of groin ache, easily treated by the topical application of a bag of frozen peas.

I had a vasectomy done in my early thirties. Can't complain, really.

It was a short operation and I'd much rather re-do that than go to the dentist and have my cavities drilled. The side-effects mentioned in the article aren't really a problem, at least in my part of the world. Hadn't even heard of them myself, actually.

After the operation, my balls were a bit swollen for a few days but it didn't hurt and I was back in bed on maybe 3rd of 4th day. Everything has been like before except that I score an exact 0% in the fertility test. And have lots of fun with my wife without anybody having to remember to take pills or enjoy some extra hormones (which I wouldn't like).

I probably would have traded messing with condoms or my wife's contraceptives to this new solution. But now that a vasectomy became an option anyway, I wouldn't have had much incentive to even try it out.

Bizarre to be giving contraceptive advice on HN, but you should really look into IUDs. They're far less hormonal than the pill, and only require maintenance every 5 years.

Some types of IUD do not use hormones, at all. Copper IUDs actually operate on the sperm, similarly to the procedure we're discussing.

IUDs, unfortunately, got a bad rap in the 70s, because of a dangerous design flaw, but they're quite safe now, and in use all over the world because of their low cost and ease of use (nothing to remember, no pills to take, nothing to put on).

Some people do not do well on IUD's (huge increase in cramping, excessive bleeding etc).

There might have been advances on IUDs, but my mother had a very bad time with one (she had to be operated on to remove it).

To second yahelc's post... definitely look into IUDs. My SO has been on the non-hormonal (copper) one for 2 years. The only downside was her first cycle post-insertion being rather painful. They are covered by most health insurance plans -- heck, she was on the state's insurance and even they covered it.

A 100% effective, low maintenance, reversible birth control method could have an incredible effect on the future of the species. I'm guessing the benefits of fewer unwanted children will be incredible. The possible downsides include a dangerously low birth rate and forced temporary sterilization, but I think the long term effects will be very positive.

I don't get the part about "forced temporary sterilization."

If people want to force you to be sterile, wouldn't they use a different method?

For places with runaway population growth that might be interested, a temporary, effective, and low-maintenance method might be more politically palatable than the alternatives.

"temporary"

e.g. Offer people generous welfare if they elect to undergo this temporary birth control procedure.

Yes, you're right. This discovery won't change anything in that regard. I was thinking about 1984-like scenarios that are very unlikely.

You are correct. Except for that part of the population that believes contraception is immoral. Or that rather large part of the population that can't afford the procedure or choose to remain ignorant of even basic contraception.

Something like this is certainly more convenient, but ultimately the best method is education.

> Except for that part of the population that believes contraception is immoral.

And since that belief is evolutionarily beneficial, you can see how it would eventually turn into a bigger and bigger problem...

"Except for that part of the population that believes contraception is immoral"

If you're thinking of Christians, it isn't necessarily all-or-nothing. Although I believe the Catholic church disapproves of all contraception, Protestants typically approve of anything that prevents fertilization. Once the egg is fertilized, it's considered a human life worthy of protection; prior to that, the egg and sperm are just cells. So this would be considered fine.

And quite a lot of Protestants are perfectly happy even with methods that may result in the loss of some fertilized eggs. And many, many Catholics use contraception, whatever they're theoretically supposed to think about it.

Most of the Catholic theologians I've run into/read about/heard about are fairly pragmatic about this sort of thing (especially the nuns.) There's the law, and then there's what people do, and then there's what people can do better even if they don't meet God's standards.

As for Protestants, you'll find many who agree with the Catholics, many who agree with what you've called typical, and many who consider human life to begin at birth. But most people have a loose affiliation with their denomination, and I don't think there's much that can be called typical about the rank-and-file Protestants or Catholics for that matter.

Education-only programs have abysmal success rates. I agree that condoms+ignorance isn't a winning plan either, but don't knock cheap, effective and hard-to-misuse contraceptives.

dangerously low birth rate will be the biggest impact in long-long term - i wont be surprised if every other men uses this technique secretively to NOT to have a child ... as someone mentioned here "A SEXUAL REVOLUTION" is underway ...

We already have a 'dangerously low birthrate' in the US (and in many other countries from France to Singapore). By this I mean a working-age population too low to support the retirement costs of the preceding generation. Practically speaking, however, this can be offset by immigration and the demographics should have smoothed themselves out by around 2030 or so.

i won't be surprised if eventually small demographic countries banning this procedure :-)

Now if only they can figure out how to do it without surgery.

Any method to do it without surgery would be even more invasive than surgery. Off the top of my head, the only thing I can think of[1] is inserting a long flexible tube down the urethra, hoping that it ends up in the right place (it's not very helpful if it ends up in the bladder), and then sending RISUG through it. Likely to be very painful and not work particularly well.

[1] There are only so many ways to get to the vans deferens without surgery, so I'm not too worried about missing something obvious.

Or nanobots, I suppose, whenever we get those. That doesn't seem likely to be any time soon, sadly.

If this procedure gets popular enough to change humanity, I'm sure it will. Right now, it's being performed by only one doctor in India and he's not accepting help.

I have nothing to add except that reading the description of the process made me feel physically uncomfortable.

That's because you've got a physical identifier of this concept in your mind. Does the idea of a pacemaker feel bad? Probably not, because your "heart" is an abstract idea--you'll probably never see it with your own eyes. A lot of professors teaching dissection have noted your feelings, girls in general don't have a squeamishness to overcome in testicular dissection since they don't have that externality of organs.

Just reading your comment made me squeamish. Very squeamish.

Wow I never associated squeamishness with physicality/abstractness of the idea. It does seem to hold up!

Me too. I have had to lie down in the past from dizziness just from reading articles that described 'body cuts/surgeries' in that level of detail.

sudonts response below is also noted, and agreed with.

I would sign up for this procedure in a heartbeat, but it still doesn't get around the (albeit not perfect) STD protection condoms can provide. If this takes off, people probably won't wear condoms most of the time, and the number of people being diagnosed with STD's will skyrocket.

Could be. The question you suggest is then: do we keep this off the market to protect humanity from itself? Should we retract oral contraception on the same grounds? There are many inferences that could be hand-waved here, but, fundamentally, RISUG increases the range of options related to reproductive choice, no more.

No, I'm not suggesting that at all, merely stating an observation. As long as people know the operation doesn't protect you from contracting STD's, that's good enough for me. It's their choice whether to still use a condom or not. In my opinion it can't get to market fast enough! Even if it doesn't end up being 100% effective, it's another layer of protection.

Education is always important, agreed.

If this takes off, people probably won't wear condoms most of the time, and the number of people being diagnosed with STD's will skyrocket.

I don't understand this thinking. To me condoms have always been about STD protection and not pregnancy prevention. I'd like to think for most people this idea will not change. I mean if you barely know a girl and she tells you that she's on the pill so you don't need a condom that should be a giant, screaming in your ear red flag to put your clothes back on and run home. I don't see how this will be any different if a guy tells a girl the same thing.

I think for most people it's about pregnancy prevention and not STD prevention. Ask any college kid why he wears a condom, he'll tell you it's because he doesn't want kids right now, not because he's afraid of getting STD's. Although I agree STD prevention is a great ancillary benefit, and it's why I'd still wear one even after an operation like this. But tell a 20 something college kid he won't have to worry about unwanted pregnancies if he get's this operation, the first thing out of his mouth will be an exuberant declaration of how he won't have to worry about buying condoms anymore.

I'm just curious, where do you live? I live and attend university in Norway, and I must say, I don't think I know anyone that uses condoms on regular basis. Every girl I know uses an IUD or is on the pill, and most people I know get checked regularly. I know Norway is the "world leader" in one night stands [1], and has one of the most well educated populations in the world. Still, condom use is abysmally low. I wonder why this is? Every time I go to the states, I'm reminded how different the "average american youth" views the condom.

[1] http://www.aftenposten.no/english/local/article633160.ece

The US. Keep in mind I went to college over ~10 years ago.

From college on most women I know were on some form of birth control to the point where I assumed most women are. Post high school, condoms were never about stopping pregnancy but avoiding STDs.

Most people in the States have never heard of IUDs sadly. That leaves condoms as the primary hormone-free contraception option.

This seems targeted as an alternative to a vasectomy, which also does not prevent STDs.

If the operation was cheap enough, I'm betting the younger generation will use it as an alternative to condoms, then get it reversed when they're ready. I'd get it done as soon as it came to the US, and I'm only 22. One less thing to worry about.

Will this cause an increase in sexually transmitted diseases? If straight men don't have to wear condoms for pregnancy-avoidance, and straight men & women don't like to pretend/boast that they've had lots of sex (unlike gay couples), then the pressure to go bareback (without a condom) increases and there might be more HIV/AIDS/STIs

>straight men & women don't like to pretend/boast that they've had lots of sex (unlike gay couples), then the pressure to go bareback (without a condom) increases and there might be more HIV/AIDS/STIs

If I'm reading this right, you're under the impression that a condom protects you against the vast majority of STIs, correct?

Yeah no. Condoms are primarily preventative towards towards diseases that are spread via Semen, vaginal fluids, and skin to skin contact only on the area it covers. Syphilis, Herpes( which can also be spread via oral sex ), Genital Warts, and crabs as a loose example ( There's more ) are not prevented by a condom. Aside from HIV/Aids ( in which case African American women are the highest rate of infected ) that quip was pointless as was this post.

Yes, you're right that STDs can still be spread with condom use, but with condoms the odds are better.

Probably not. Insurance already covers vasectomy since it's much cheaper than paying for a pregnancy/childbirth/child medical expenses/etc and it doesn't seem to have resulted in increase in STD.

Odds are, if you have medical insurance, you can get a vasectomy for a co-pay of $20 and the procedure only takes about 15 minutes.

I'm fairly sure that Planned Parenthood in the US also does it cheaply.

My gut tells me that the guys who are responsible enough to get vasectomies if they really don't want kids are also responsible enough to wear condoms. The converse is likely also true!

There's an important difference between this procedure and a vasectomy: a vasectomy is not reliably reversible. Because of that, the only men who get vasectomies are those who are done having children. Some men might make that decision on their own, but most men don't make that decision until they are married (or in at least in committed, long-term monogamous relationship) and have discussed it with their spouses/partners. People in relationships like that are generally at a much lower risk of STDs because of the monogamy.

If you roll out a treatment that is just as effective as a vasectomy, but is 100% reversible, and a whole new class of men will enter into the picture: men who aren't yet ready for fatherhood, but who want to be fathers someday. Many of them will not be in monogamous relationships. Some of them will not consider the risks of STDs as rationally as they considered the risks of pregnancy.

Yet another illustration about how broken the health care system is in the US. Pharmaceutical and medical device companies are disincented to produce cost effective treatments, it's really an outrage. Medicine in the US is geared towards costly treatments that are needed on a recurring basis; we're inundated with marketing and profit driven medicine. IMO, the NIH and FDA should be promoting a research-rewarded system that promotes cost effective and potentially society-shifting treatments such as RISUG.

i always wonder why dont we have atleast one country on this planet that has some kind of fast-track approval process for this kind of research and solutions ???

also it shouldn't be costing millions - something like this should be self funded by the govt. ... tax payers are made to pay for many stupid things but research like this should be treated as "Too Big To Fail" !!!!

Yeah, I was thinking this would be a great kickstarter project. "Pledge $100 or more: get this procedure done for no additional cost, once available."

Fantastic Idea - crowd financing at its BEST !!

>“If it’s no longer a crazy Indian idea and it’s something that’s working in India and in rabbits in Ohio and in the first 20 men in the US,” Lissner says, “then there’s got to be a point where there’s just no excuse for a Gates or a Buffett not to get on board.”

The words "crazy Indian idea" hit me as offensive at first. But I guess that's just the way the world perceives us and its up to us to change that.

All On One Page: http://www.wired.com/magazine/2011/04/ff_vasectomy/all/1

There should be a NSFW in the link title.

seeing any kind of operation done in that region I come to think a condom is actually a pretty good idea

Now if only they could invent something revolutionary for treating infertility...

It's always easier to destroy/disable than it is to create/enable.

Infertility is a complex problem with multiple possible causes.

Totally agree. Just wish there was same "easy" way to do opposite.

It should warn me "DO NOT CLICK IF YOU DON'T WANT TO SEE HAIRY BALLS"

Bonus points for reading the whole article without flinching!

If you just lost your appetite for the entire day when you saw the single shot on that video, you are not alone.

I am greatly enjoying my chicken with mac and cheese and mashed potatoes, thank you. (I did flinch, though.)

The video is excruciating. Make sure you watch it.

hello NSFW.

I have a two-year old daughter. I want more kids, not fewer. If I had known how amazing raising a kid was, I would have started sooner. Smart people need to bring more smart people to the world.

And yes, I've worked in startups and founded a company last year; we're ending beta this June. I can work a little bit extra before she gets up, and after she goes to sleep. The one thing that has suffered the most has been the time we used to spend watching a few shows on TV. Every minute I spend with our daughter is worth more than any evening of TV. Every new phrase is a delight.

Not to mention that your daughter is a creative person who will solve all kinds of problems and improve the lives of the people she encounters. Sadly, theoretical "other people's children" are assumed to be dead weight who consume food and oil and do nothing else. Some people are actively misled into living harmful lives and a rare few generate their own evil motivations, but the majority simply live up to low expectations set by the people who prefer widespread contraception over births.

A startup that changed the way intelligent people view children would change the world in a much more dramatic and useful way than this contraceptive medicine.

You comment puzzles me. Hopefully you will reply below.

Are you discounting the value of reversible birth control based upon your feelings at a certain point in time? Also remember that evolution has probably programmed children be "amazing" until they can fend for themselves.

Presumably you're comfortably middle-class in a first-world country with a good social contract (yes, kid-friendly services like subsidized/free public schools and universities are a safety net). You need to step back and think about societies which don't have such luxuries.

And sorry to get all personal on you, but do you use ANY scientific form of birth control? Are you ok with you/your SO getting pregnant every year (unsure about your gender, hence hedging)? That's usually what happens w/o birth control. If you do use scientific birth control (so-called "rhythm" method etc don't count) then your comment is pretty hypocritical.

I started two write a response, twice, but your arbitrary assumptions don't deserve answers. Your general tone does not indicate a desire for dialogue.

Your original post is completely off-topic, or do you actually want everyone to have as many kids as humanly possible? That would equal 1 kid a year, do you want everyone to have 1 kid a year, even teenagers, grandmas..everyone? No? Then stay on topic, which is prevention.

This is going to change the world ... this is by far going to have deepest sociological impact (good & bad) on the society ... because many men will use this secretly without telling their partner to avoid having kids ... which eventually will bring enormous decrease in population ...

Now someone should come out with novel technique to avoid STD without using condoms ... combination of these 2 techniques will be VIOLA !!!!! :)

We'd see the return of the sexual revolution.

Exactly - this takes away the one of the biggest fear a man has while having sex ...

because many men will use this secretly without telling their partner to avoid having kids ... which eventually will bring enormous decrease in population ...

I doubt there are that many men who want to secretly make themselves infertile in order to not give their wives the children they want to have.

combination of these 2 techniques will be VIOLA

I'm really not sure what violas have to do with it.

VIOLA = one stone will kill multiple birds (no condoms, no pills, no snipping , NO FEAR of having unwanted Kids, No FEAR of STD, etc. etc. etc.)

Viola is the american far-too-spread wrong spelling of the french expression voilà, which could be translated roughly to "behold" or "that's it".

Et voilà :)

What I found amusing was that not only did he misspell voila (and I'm not gonna be pedantic about the accent mark because I'm too lazy to remember how to type it myself), he also managed to use it in a place that voila wouldn't have made sense either.

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