A long-standing conversation between couples since the introduction of the birth control pill back in the 1960s has been the lack of an oral contraceptive for men—or many options at all for men to prevent pregnancy.
In contrast to the array of therapies and devices for women, including intrauterine devices, hormonal implants and birth control shots, men are essentially limited to two choices: condoms or vasectomies.
But San Francisco biotech startup YourChoice Therapeutics is trying to make the first-ever male birth control pill a reality. It just launched an early-stage human clinical trial for its pill, known now as YCT-529, and 16 volunteers in the United Kingdom are receiving initial dosages with the study expected to last until next summer.
The Phase 1 trial is meant to determine the safety and proper dosage of the drug. Preclinical studies in mice showed the drug to be 99% effective and 100% reversible.
YourChoice, which was founded in 2018 and was incubated via Y Combinator, raised a $15 million Series A round last year led by Silicon Valley venture capital firm Future Ventures. At the time, YourChoice CEO Akash Bakshi tied the company’s effort to create a new form of male contraceptive to the Supreme Court’s decision to overturn Roe v. Wade, which legalized abortion nationwide.
“Half of pregnancies globally are still unintended, even in the U.S.,” said Logan Nickels, the research director of the Durham, North Carolina-based Male Contraceptive Initiative, which advocates for and provides financial support to pharmaceutical companies working to help men prevent pregnancy, including YourChoice. “We’re in a world where contraceptive burden and opportunity are not equally distributed. Men lack that autonomy.”
As opposed to the hormone-based therapies that are the main mechanism in female birth control bills, YourChoice bills its drug candidate as “hormone-free.” The pill works by inhibiting a protein that is key to sperm development.
That contrasts with other drug candidates—some of which are further along than YourChoice’s YCT-529—that suppress testosterone as a method to limit sperm production. YourChoice argues hormonal therapies come with the risk of side effects outside of the reproductive system.
“We believe this will be more attractive to men, most of whom view pregnancy prevention as a shared responsibility even despite today’s limited contraceptive options, which are permanent or only moderately effective,” Bakshi said in a statement. “The dearth of options reinforces the centuries-old view that pregnancy prevention is ‘a woman’s responsibility.’”
One of the major reasons for the lack of progress in male contraception, according to Nickels, is a funding gap tied to questions about the financial viability of a birth control pill for men. Another challenge is scientific. Instead of trying to prevent fertilization of one egg, male birth control has to contend with the problem of the high rate of sperm production.
“Men make millions of sperm a day. To get an effective contraceptive, you need to impede a significant number of them if not all of them,” Nickels said. “There are many medical and scientific challenges, but anything is overcomeable with enough focus time and money.”
So how long and how many dollars are we away from actually having a new option on the market? Nickels said a common joke in the industry is that “a male contraceptive has been 10 years away for 50 years.”
Still, he estimated that a male contraceptive medical device could be on the market in the next five years. Nickels’ organization is supporting the development of a device that would temporarily block the sperm traveling through the vas deferens from biotech firm Contraline.
A pill is still potentially a decade away, even on an optimistic time frame, he said.
But Nickels said he’s buoyed by the number of new contraceptive options that have gone into clinical trials in the past few years, as well as a larger sea change socially in the conversation around reproduction.
“What I’ve seen is men wanting to take a more active role in contraception and reproduction,” Nickels said. “There’s been a change in the temperature of the room, and that appetite is much larger now.”