The joy of leading a full-fledged family life without any riders on "making love" with the life partner and at the same time not begetting a baby is more or less a distance possibility with the conventional family planning techniques, given the hassles/precautions/compromise/side-effects that a couple has to undergo. Most of these procedures are for females and they invariably come with their own problems. Till Vasectomy for men came into practice, the contraception or the responsibility of "family planning" squarely rested with woman. The use of condom as a contraception is mostly adopted by men for want of anything safer and better. One has to make compromise with the extent of "joy" when going in for condoms.

One can not think of anything other than the purchase of an ice-cream as impulsive as the desire "to make love". Both are 'impulsive' in nature and visibility and easy availability are the prime motivations to go for them. Lack of condom availability at the needed moment is a major risk. In our Indian society, even today, the use of condom is not that high as one would wish the men community to share the burden of family planning. The "psychological resistance" to the use of condom is the major impedance. The use of male pill (a hormonal method) has its own side-effects.

Another method available for men is to go for conventional 'vasectomy'. In this family planning procedure, the vas deferens is cut and tied. This would inhibit the flow of sperm. Although the male organ (tube) would erect due to enhanced blood circulation while "making love", the inhibition to flow of sperm would come in the way of experiencing orgasm. This is viewed as 'disappointing' and also suspected to affect the psychology and physiology of the men over a period of time as there is no true "outlet" for the 'desire/passion'. It is also viewed as a technique against the natural process of fluid (androgen/semen) secretion and its flow. Also, even amongst the 'informed' people, vasectomy is synonymous to 'impotency'. Probably, a specialist could dispel some of these beliefs/fears/myths. However, the point is that 'vasectomy' as a male contraceptive method is almost irreversible. Only 2% of all contraceptive surgeries in India are vasectomies. Even if the vas deferens is rejoined, fertility would be low as the sperms would be destroyed by the high level of antibodies spawned by the surgery.

The above arguments clearly bring out one point and that is the need for a safe, convenient and a fool-proof family planning procedure. Most importantly, there must be a possibility to 'reverse' the procedure as and when the man decides to go for a baby. There should not be any side effect and there should not be any assault on the manhood i.e. inhibition to sperm secretion, its flow, and the physical contact. This has been the 'holy grail' for scientists working on male contraception.

India Today, in its June 10, 2002 issue, brought out a brief overview of an indigenously developed technology that promises all that men ask for. This 'ideal' male contraceptive technology is called RISUG - Reversible Inhibition of Sperm Under Guidance. This research was pursued for the last quarter century by Dr. Sujoy K Guha, a professor in Biomedical Engineering department of Indian Institute of Technology (IIT) Delhi & All India Institute of Medical Sciences (AIIMS). Dr. Guha and his team is collaborating with Indian Council of Medical Research (ICMR) to produce this non-hormonal male contraceptive technology.
This simple procedure involves an injectible drug. This drug is composed of styrene maleic anhydride (SMA) and dimethyl sulphoxide. A 50 mg of this drug is injected into the vas deferens. Vas deferens are the duct that transports sperm which is produced by the epididymis of the testicles. This duct is neither cut nor any part of it is removed. The drug injected into the vas deferens deactivates/immobilises the sperm in the semen. Thus, the drug neither affects the formation and flow of semen nor diminishes the libido. The whole procedure is so simple that it can be completed within 10 minutes by a certified Medical Practitioner. Then comes a question as to how long this drug would perform its duty. Depending on the individual, this drug has an effect from 6-15 years. There is practically no incubation/lag time and the drug comes into effect less than an hour after injection.

Now, coming to the interesting aspect- "reversibility'- of this technology, it is to be noted that the procedure can be reversed or in other words, sperms can be activated either by injecting a solvent to flush out the drug or by using a low voltage electrical impulses which would in turn contract the vas deferens and expel the drug. Although RISUG is currently undergoing final phase of human trials in India, no 'reversal' trials on humans have been carried out. The 'reversal' was proved to be 100% efficient in rhesus monkeys. However, the final test of strength of RISUG lies on the efficacy of its 'reversal' in humans as the attractive aspect of RISUG is the possibility to 'reverse' the procedure.
It should also be proved beyond doubt that the 'inhibition' dose and the 'reversing' solvent do not have any side effect especially with regard to hormonal secretions and their functions. If the 'reversal' is done using electrical impulses, don't they damage the duct i.e. vas deferens and also the delicate nerves surrounding it? Will it inflict an unbearable pain when injecting 'inhibition' dose as well as 'reversal' solvent? Will there be a prolonged pain for some days after taking the injection? The "India Today" science article mentions that there is no damage to the surrounding tissues. Also, a local anesthetic like xylocaine is advised to avoid any pain. Absence of any side effect of this local anesthetic needs to be established. It is argued that the alkalinity of dimethyl sulphoxide (DMS) would damage the tissue. To counter this, Dr. Guha says that DMS is used along with an acidic compound SMA (Styrene Maleic Anhydride) and hence there would not be any risk due to alkalinity. In such a case, has the optimal pH and the composition of DMA and SMA arrived at for the best performance? Above all, is there any threat of genetic mutation due to the usage of such chemicals?

It should also be made clear if there is a range of age before and after which this technology may not work or not tested. If a male has hormonal defects or any other problems in his physiology, can he go for RISUG? If the sperm count or vitality is high, will RISUG work even for those individuals? Will the sperm mobility and viscosity of semen influence the success of this technology? A comprehensive note on this technology would positively influence the male community to go for it. The suspected mild swelling of the scrotum after the injection would be a temporary inconvenience.

RISUG can also be used as a spermicide by women. It can be sold as a 'condom' jelly. This can also be used as an anti-bacterial agent and this can prevent AIDS and other sexually transmitted diseases. The RISUG kit comprises a 50 mg dose, a needle, and a syringe. This kit costs about Rs. 100 per pack. India can be proud of her invention as the intellectual property rights of this technology rests with India. IDPL and major foreign pharma companies have shown a keen interest on this technology. RISUG is undergoing final phase of trial and is likely to be available for use in 2003 after the completion of trials.
There is no doubt that males would go for it if its reversibility, absence of pain, swelling and side-effects, nil-chance of genetic mutation, and no hindrance to the orgasmic pleasure during copulation are proved beyond doubt across the age groups and races.

Hats off to Dr. Guha and his team!