Burden Of Unintended Pregnancy Research Articles

Cost-effectiveness analysis of levonorgestrel-releasing intrauterine system (LNG-IUS) 52 mg versus other long-acting reversible contraceptives for contraception in Spain

Introduction Condoms and combined oral contraceptive pills are widely used in Spain with high failure rates. Long-Acting Reversible Contraceptive (LARC) methods offer better efficacy and adherence and reduce unintended pregnancies (UP) compared with short-acting reversible contraceptive (SARC) methods. Objective To assess the cost-effectiveness of LNG-IUS 52 mg (Mirena®) versus other LARC for contraception in Spain. Materials and Methods A Markov model with annual cycles and an eight-year time horizon was developed from the Spanish national healthcare system (NHS) perspective, considering costs for contraceptive method acquisition, health care resources (HCR) and UP. Effectiveness was based on failure and discontinuation rates. Sensitivity analyses were performed to test the model’s robustness. Results LNG-IUS 52 mg (Mirena®) resulted in lower costs and fewer UP versus LNG-IUS 13.5 mg (Jaydess®), Implant (Implanon®) and Copper IUD. LNG-IUS 52 mg (Levosert®) prevented the same UP events at a higher cost. LNG-IUS 19.5 mg (Kyleena®) was the most effective option, due to a lower discontinuation rate. Conclusions LNG-IUS 52 mg (Mirena®) is the least costly LARC, driven by lower acquisition costs and reduced HCR utilisation. Increasing LNG-IUS 52 mg (Mirena®) uptake in contraception could generate further cost savings for the Spanish NHS and reduce economic burden of UP.

The burden of unintended pregnancies among Indian adolescent girls in Bihar and Uttar Pradesh: findings from the UDAYA survey (2015–16 & 2018–19)

BackgroundUnintended pregnancy severely affects the health and welfare of women and children, specifically if women are young and vulnerable. This study aims to determine the prevalence of unintended pregnancy and its determinants among adolescent girls and young adult females in Bihar and Uttar Pradesh. We believe the present study is unique as it examines the association between unintended pregnancy and sociodemographic factors among young female population in two states of India from 2015–19.MethodsThe data for the present study is derived from the two-wave longitudinal survey “Understanding the lives of adolescents and young adults” (UDAYA) conducted in 2015–16 (Wave 1) and 2018–19 (Wave 2). Univariate, bivariate analysis along with logistic regression models were employed.ResultsThe results revealed that 40.1 per cent of all currently pregnant adolescents and young adult females reported their pregnancy as unintended (mistimed and unwanted) in Uttar Pradesh at Wave 1 of the survey, which decreased to 34.2 per cent at Wave 2. On the contrary, almost 99 per cent of all currently pregnant adolescents in Bihar reported their pregnancy as unintended at Wave 1, which decreased to 44.8 per cent at Wave 2. The sociodemographic factors like age, caste, religion, education, wealth, media and internet use, knowledge and effective contraception highly impacted unintended pregnancy in Bihar and Uttar Pradesh. The longitudinal results of the study revealed that place of residence, internet use, number of wanted children, heard about contraception and SATHIYA, use of contraception, side effects of contraception, and the confidence in getting contraceptives from ASHA/ANM did not appear significant predictors at Wave 1. However, they emerge significant over time (Wave 2).ConclusionsDespite many recently launched policies for adolescents and the youth population, this study comprehended that the level of unintended pregnancies in Bihar and Uttar Pradesh stands worrisome. Therefore, adolescents and young females need more comprehensive family planning services to improve their awareness and knowledge about contraceptive methods and use.

Emerging concepts in male contraception: a narrative review of novel, hormonal and non-hormonal options.

Access to reliable contraception is a pillar of modern society. The burden of unintended pregnancy has fallen disproportionately on the mother throughout human history; however, recent legal developments surrounding abortion have sparked a renewed interest in male factor contraceptives beyond surgical sterilization and condoms. Modern efforts to develop reversible male birth control date back nearly a century and initially focused on altering the hypothalamic-pituitary-testes axis. These hormonal contraceptives faced multiple barriers, including systemic side effects, challenging dosing regimens, unfavorable routes of delivery, and the public stigma surrounding steroid use. Novel hormonal agents are seeking to overcome these barriers by limiting the side effects and simplifying use. Non-hormonal contraceptives are agents that target various stages of spermatogenesis; such as inhibitors of retinoic acid, Sertoli cell-germ cell interactions, sperm ion channels, and other small molecular targets. The identification of reproductive tract-specific genes associated with male infertility has led to more targeted drug development, made possible by advances in CRISPR and proteolysis targeting chimeras (PROTACs). Despite multiple human trials, no male birth control agents have garnered regulatory approval in the United States or abroad. This narrative review examines current and emerging male contraceptives, including hormonal and non-hormonal agents.

Positive Deviance for Dual-Method Promotion among Women in Uganda: A Qualitative Study.

Dual-method use is the most reliable form of protection against unintended pregnancies and human immunodeficiency virus/sexually transmitted infections (HIV/STIs). Although dual-method use remains uncommon among women in stable relationships, some women do practice it. In this study, we explored the barriers that make dual-method use rare and the behaviors of women who practice dual-method use using a positive deviance framework in Uganda. We screened 150 women using highly effective contraceptives at five health facilities. We identified nine women who practiced dual-method use and 141 women who did not. In a qualitative study, we conducted in-depth interviews with all nine women practicing dual-method use and 10 women randomly selected out of the 141 who did not. We performed a thematic analysis using the positive deviance framework. Regardless of practicing dual-method use or not, women faced perceived barriers against dual-method use, such as partner’s objection, distrust, shyness about introducing condoms into marital relationships, and limited access to condoms. However, women practicing dual-method use had higher levels of risk perception about unintended pregnancies and HIV/STIs. They also engaged in unique behaviors, such as influencing their partners’ condom use by initiating discussions, educating their partners on sexual risks and condom use, and obtaining condoms by themselves. These findings will be useful in developing effective community-led and peer-based interventions promoting dual-method use to reduce the dual burden of unintended pregnancies and HIV/STIs among women in Uganda.

Women's perceptions of factors contributing to unintended pregnancy and actions to prevent it in the Eruwa community, Oyo State, Nigeria

Introduction: Unintended pregnancy, used synonymously with unplanned and unwanted pregnancy, contributes to a high health burden among women of reproductive age in many countries. This study focused on women's perceptions of factors contributing to unintended pregnancy and actions that can be taken to prevent it, in Nigeria. Objectives: To collect data that will inform preventive education and support for women and help to reduce the burden of unintended pregnancy, especially among women at a community level. Method: A descriptive cross-sectional design was used. 338 women of childbearing age were selected systematically from the town of Eruwa using a multistage sampling technique. A pre-tested self-structured questionnaire was issued to identify sociodemographic data of participants and their perceptions of factors contributing to unintended pregnancy and actions that can be taken to prevent this. The Chi squared test determined if sociodemographic characteristics were significantly associated with perceptions of effective actions. Results: Peer influence, rape, and lack of parental care were most commonly perceived as factors contributing to unintended pregnancy. Abstaining from sex, preconception counselling, and self-control were commonly identified as effective preventive measures. The perceptions that the use of arm implants or self-control are effective actions to prevent unintended pregnancy were significantly associated with the marital status of participants (P= 0.001 and 0.002, respectively). Several perceived methods for effective actions in preventing unintended pregnancy were significantly associated with the age of participants, including arm implants (P<0.000) and the calendar contraceptive method (P= 0.004). Conclusions: These findings highlight several factors that women in Nigeria believe contribute to unintended pregnancy. Efforts should be directed at ensuring victims of rape are treated fairly and without discrimination, as well as encouraging positive preventive actions, such as contraceptive use, to reduce unintended pregnancy and contribute to the reduction of maternal mortality and morbidity.

Factors Influencing Unintended Pregnancies amongst Adolescent Girls and Young Women in Cambodia.

Background: Unintended pregnancies in Cambodian youth are a major reproductive health concern with detrimental personal and socioeconomic consequences. A social ecological model was used to identify sociodemographic factors potentially associated with unintended pregnancies, and an analysis of data from the 2014 Cambodian Demographic and Health Survey was used to determine associations. Methods: Weighted data were analysed using multiple logistic regression analyses for 3406 Cambodian sexually active single, in union or married females aged 15–29 years. Results: The prevalence of unintended pregnancy was 12.3%. Unintended pregnancy was significantly associated with younger age groups (15–24 years), multiparity, history of abortion, and current use of modern contraceptive methods. All women had an increased likelihood of unintended pregnancy when the husband alone or someone else in the household made decisions about their access to healthcare. Conclusion: The burden of unintended pregnancies is associated with young age, multiparity, history of abortions, unemployment, and low autonomy for accessing healthcare. Multi-pronged, holistic reproductive and sexual health program interventions are needed to increase literacy and accessibility to modern contraception and to raise awareness about women’s health and status in Cambodia.

The use of long-acting reversible contraceptives in Latin America and the Caribbean: current landscape and recommendations.

STUDY QUESTIONCan the high rate and associated burden of unintended pregnancy (UP) and adolescent pregnancy in Latin America and the Caribbean (LAC) be reduced through wider access to and use of long-acting reversible contraceptive (LARC) methods?SUMMARY ANSWERStudies show that impoved access to and use of LARC methods is an effective tool for reducing the high rates of UP, unsafe abortion and abortion-related complications, and maternal deaths (as well as reducing their social and financial burden), and we have provided recommendations to help achieve this in LAC.WHAT IS KNOWN ALREADYLAC comprises 46 countries with 650 million inhabitants, and shows large disparities in socioeconomic development, access to health services and attention to sexual and reproductive health rights. The exercise of these rights and universal access to sexual and reproductive health (SRH) programmes is a key strategy for improving maternal health by reducing the number of UPs, the rate of women’s and child mortality and morbidity, and the number of unsafe abortions. The implementation of SRH programmes in the region has contributed to a decrease in pregnancy rates of more than 50% over 40 years. However, despite this progress, the numbers of UP and adolescent pregnancies are still among the highest worldwide, which can be attributed in large part to the low prevalence of use of LARC methods.STUDY DESIGN, SIZE, DURATIONThis is a position paper with the objective of reviewing the magnitude and burden of UP in LAC, as well as available LARC methods and barriers to their access, with the goal of increasing knowledge and awareness among healthcare professionals (HCP), policymakers and the general public about the potential to reduce UP rates through the increased use of LARC.PARTICIPANTS/MATERIALS, SETTING, METHODWe searched the electronic databases of PubMed and EMBASE to identify studies published up to May 2017. We also searched for websites regarding LAC, LARC methods, and UP including, for example, those from the United Nations, the World Health Organization, Pan American Health Organization, the Alan Guttmacher Institute and the United States Agency for International Development. Studies were included if they investigated mainly UP and their consequences as well as the use of LARC methods in the region. During 3 days of meetings, the importance of the studies identified and the appropriateness of inclusion were discussed.MAIN RESULTS AND THE ROLE OF CHANCELAC is not one unit and shows great ethnic diversity as well as economic and cultural differences among the various countries. These differences must be taken into account when developing policies related to disseminating information and combatting misinformation regarding the use of LARC among different audiences, such as adolescents and young women, nulligravidas, indigenous populations and women with disabilities. Furthermore, only some governments have made efforts to increase accessibility to LARC methods, and there is a need to implement training programmes for HCPs, launch education campaigns for the general public, increase access and review the cost-benefit analyses specific to LARC, which have already demonstrated that the upfront cost of LARC is less than the cummulative expense of short-term contraceptives. Recommendations to achieve these goals are presented.LIMITATIONS, REASONS FOR CAUTIONKnowledge and awareness of the contraceptive method itself and of the mix of individual countries in the region is essential to the development of specific strategies and actions, tailored to each particular country situation, aimed at increasing access to modern contraceptive methods, especially LARC.WIDER IMPLICATIONS OF THE FINDINGSHealthcare systems in LAC should consider LARC as a primary option for decreasing UP and adolescent pregnancy. Disseminating information, increasing awareness of their efficacy, removing barriers and improving access to LARC methods are the urgent actions recommended for government, academia, professional organizations, insurance companies and policymakers in order to address this major public health problem in LAC.STUDY FUNDING/COMPETING INTERESTSThis manuscript was supported by a grant from the Americas Health Foundation (AHF), a 501(c)3 nonprofit organization dedicated to improving healthcare throughout the Latin American Region. LB and IM received additional support from the São Paulo Research Foundation (FAPESP) award # 2015/20504-9. The authors declare no conflict of interest.

Future directions in performance measures for contraceptive care: a proposed framework

In the United States, almost half (45%) of the approximately 6 million pregnancies each year are unintended [ [1] Finer L.B. Zolna M.R. Declines in unintended pregnancy in the United States, 2008–2011. N Engl J Med. 2016; 374: 843-852 Crossref PubMed Scopus (1269) Google Scholar ]. These statistics indicate that many women experience barriers to achieving their desired reproductive outcomes, which has potential adverse consequences for women, children and society at large, such as higher rates of preterm birth, lower rates of breastfeeding and lower educational attainment [ 2 Conde-Agudelo A. Rosas-Bermudez A. Kafury-Goeta A.C. Birth spacing and risk of adverse perinatal outcomes: a meta-analysis. JAMA. 2006; 295: 1809-1823 Crossref PubMed Scopus (765) Google Scholar , 3 DeFranco E.A. Seske L.M. Greenberg J.M. Muglia L.J. Influence of interpregnancy interval on neonatal morbidity. Am J Obstet Gynecol. 2015; 212: 386.e381-386.e389 Abstract Full Text Full Text PDF Scopus (38) Google Scholar , 4 Gipson J.D. Koenig M.A. Hindin M.J. The effects of unintended pregnancy on infant, child, and parental health: a review of the literature. Stud Fam Plan. 2008; 39: 18-38 Crossref PubMed Scopus (601) Google Scholar , 5 Sawhill I. Karpilow Q. Venator J. Families CoCa The impact of unintended childbearing on future generations. Brookings Institution, Washington, DC2014 Google Scholar , 6 Tsui A.O. McDonald-Mosley R. Burke A.E. Family planning and the burden of unintended pregnancies. Epidemiol Rev. 2010; 32: 152-174 Crossref PubMed Scopus (240) Google Scholar ]. Contraceptive care is a highly effective clinical intervention that can substantially reduce those adverse outcomes, help individuals and couples achieve their desired number and spacing of children, and save money [ 7 Foster D.G. Biggs M.A. Malvin J. Bradsberry M. Darney P. Brindis C.D. Cost-savings from the provision of specific contraceptive methods in 2009. Womens Health Issues. 2013; 23: e265-e271 Abstract Full Text Full Text PDF PubMed Scopus (30) Google Scholar , 8 Frost J. Finer L. Tapales A. The impact of publicly funded family planning clinic services on unintended pregnancies and government cost savings. J Health Care Poor Underserved. 2008; 19: 778-796 Crossref PubMed Scopus (57) Google Scholar , 9 Frost J.J. Sonfield A. Zolna M.R. Finer L.B. Return on investment: a fuller assessment of the benefits and cost savings of the US publicly funded family planning program. Milbank Q. 2014; 92: 696-749 Crossref PubMed Scopus (61) Google Scholar , 10 Sonfield A. Kost K. Institute TG Public costs from unintended pregnancies and the role of public insurance programs in paying for pregnancy and infant care: estimates for 2010. The Guttmacher Institute, New York, NY2015 Google Scholar , 11 Trussell J. Contraceptive failure in the United States. Contraception. 2011; 83: 397-404 Abstract Full Text Full Text PDF PubMed Scopus (982) Google Scholar ]. However, many women at risk of unintended pregnancy do not use contraception or use it incorrectly or inconsistently [ 12 Daniels K. Daugherty J. Jones J. Mosher W. Current contraceptive use and variation by selected characteristics among women aged 15–44: United States, 2011–2013. US National Center for Health Statistics, Hyattsville, MD2015 Google Scholar , 13 Jones R. Tapales A. Lindberg L. Frost J. Using longitudinal data to understand changes in consistent contraceptive use. Perspect Sex Reprod Health. 2015; 47: 131-139 Crossref PubMed Scopus (36) Google Scholar ], and there are documented barriers in access to and quality of contraceptive care services available [ [14] Obstet Gynecol. 2015; 125: 250-255 Crossref PubMed Google Scholar ].

The burden of unintended pregnancies: a cross sectional study

Background: Even though family planning methods and various health services are available, there is little increase in couple protection rate. The unintended pregnancy may end in termination of pregnancy of a birth of a child contributing to population explosion. Identifying the prevalence of termination of pregnancy and factors associated with the termination of pregnancy among reproductive age group women could help in determination as well as bridging the gap. Objective: The primary objective was to find out the prevalence of medical termination of pregnancy (MTP) and factors related with MTP in rural community. The secondary objective was to explore obstetric profile, to find out any association of obstetric profile and MTP. Materials and Methods: A cross-sectional, community-based observational study was conducted among 450 reproductive age group women in a study district by multistage sampling. Each participant was interviewed in detail following written informed consent. Result: Prevalence of MTP in this study was 21.88%. The high prevalence of unmet need of contraception was 42.88%, with various reasons. Most of the CPR is contributed by permanent method of contraceptives. It was found that 33.6% women had three or more children. Initial conceptions were not intended by the women. Conclusion: There is need to counsel women of reproductive age group that MTP is not a way to control unwanted birth and it is not free from risk. They should be motivated for various methods of contraception.

Direct costs of unintended pregnancy in the Russian federation.

In 2010, almost every third pregnancy in Russia was terminated, indicating that unintended pregnancy (UP) is a public health problem. The aim of this study was to estimate the direct cost of UP to the healthcare system in Russia and the proportion attributable to using unreliable contraception. A cost model was built, adopting a generic payer perspective with a 1-year time horizon. The analysis cohort was defined as women of childbearing age between 18 and 44years actively seeking to avoid pregnancy. Model inputs were derived from published sources or government statistics with a 2012 cost base. To estimate the number of UPs attributable to unreliable methods, the model combined annual typical use failure rates and age-adjusted utilization for each contraceptive method. Published survey data was used to adjust the total cost of UP by the number of UPs that were mistimed rather than unwanted. Scenario analysis considered alternate allocation of methods to the reliable and unreliable categories and estimate of the burden of UP in the target sub-group of women aged 18-29years. The model estimated 1,646,799 UPs in the analysis cohort (women aged 18-44years) with an associated annual cost of US$783 million. The model estimated 1,019,371 UPs in the target group of 18-29years, of which 88% were attributable to unreliable contraception. The total cost of UPs in the target group was estimated at approximately US$498million, of which US$441 million could be considered attributable to the use of unreliable methods. The cost of UP attributable to use of unreliable contraception in Russia is substantial. Policies encouraging use of reliable contraceptive methods could reduce the burden of UP.

The burden of unintended pregnancies in Brazil: a social and public health system cost analysis.

BackgroundUnintended pregnancy (UP) is an unmet medical need with consequences worldwide. We evaluate the costs of UP based on pregnancies in Brazil from for the year 2010.MethodsThe consequences of UP were evaluated using decision analysis based on pregnancy rates and outcomes as miscarriage, induced abortion, and live birth, which were factored into the analysis. The model discriminated between maternal and child outcomes and accounted for costs (in Brazilian currency [Real$, R$]) within the Brazilian public health service attributed to preterm birth, neonatal admission, cerebral palsy, and neonatal and maternal mortality. Event probabilities were obtained from local resources.ResultsWe estimate that 1.8 million UPs resulted in 159,151 miscarriages, 48,769 induced abortions, 1.58 million live births, and 312 maternal deaths, including ten (3%) attributed to unsafe abortions. The total estimated costs attributed to UP are R$4.1 billion annually, including R$32 million (0.8%) and R$4.07 billion (99.2%) attributed to miscarriages and births and complications, respectively. Direct birth costs accounted for approximately R$1.22 billion (30.0%), with labor and delivery responsible for most costs (R$988 million; 24.3%) for the year 2010. The remainder of costs were for infant complications (R$2.84 billion; 72.3%) with hospital readmission during the first year accounting for approximately R$2.15 billion (52.9%). Based on the national cost, we estimate the cost per UP to be R$2,293.ConclusionDespite weaknesses in precise estimates in annual pregnancies and induced abortions, our estimates reflect the costs of UP for different pregnancy outcomes. The main costs associated with UP are in those carried to parturition. The health cost of abortion represents a small proportion of total costs as these are paid for outside of the public health system. Consequently, reductions in UP will generate not only cost savings, but reductions in woman and child morbidity and mortality.

ACOG backs OTC oral contraceptive

Oral contraceptives should be available without a prescription, according to a committee opinion paper released by the American College of Obstetricians and Gynecologists (ACOG) in December 2012. The rate of unintended pregnancies remains high, accounting for approximately 50% of all pregnancies, according to ACOG, and these unintended pregnancies cost taxpayers an estimated $11.1 billion annually. ACOG argued that allowing OTC sale of oral contraceptives would increase their access and use and potentially decrease the burden of unintended pregnancies.

PIH13 The Costs of Unintended Pregnancy in Russia

To estimate the costs of unintended pregnancies (UP) over one year within the Russian health care system. We calculated direct medical costs of a UP for women aged 15-44 per 5-year age groups (average per woman and per age group) as sum of the costs of pregnancy outcomes (live birth, termination, foetal loss, ectopic pregnancy) multiplied by the proportions of each pregnancy outcome that occurred following an UP. The costs of hospital and outpatient services for each outcome were calculated on the basis of information on typical practice provided in expert panel interviews, rates of pregnancy complications from federal statistics and reimbursement rates for medical services in obligatory medical insurance in Moscow region, adjusted for the proportion of medical expenditures covered by public budgets. The costs of live births were adjusted for mistimed pregnancies, based on literature data on their proportion for age groups. The numbers of UP were assessed using data from federal statistics on overall pregnancy outcomes and literature data on the proportion of these outcomes due to unintended pregnancies only. Based on the derived numbers we estimated the distribution of UP outcomes for each age group. The average cost of UP per woman varied from 12 635 RUR (€309,68) for age group 15-19 to 17 630 RUR (€432,12) for age group 30-34. There are estimated to be annually 1 705 591 unintended pregnancies occurring in Russia, with direct medical cost amounting to approximately 26,4 billion RUR (€ 647,0 mln) annually. The highest costs are attributed to age groups 20-24 and 25-29, together accounting for 54% of overall cost burden of UP. The analysis has demonstrated that in Russia UPs elicit substantial health system costs, with the major part attributed to women aged 20-29.

Burden of unintended pregnancy in the United States: potential savings with increased use of long-acting reversible contraception

BackgroundThis study evaluated the total costs of unintended pregnancy (UP) in the United States (US) from a third-party health care payer perspective and explored the potential role for long-acting reversible contraception (LARC) in reducing UP and resulting health care expenditure. Study DesignAn economic model was constructed to estimate direct costs of UP as well as the proportion of UP costs that could be attributed to imperfect contraceptive adherence. The model considered all women requiring reversible contraception in the US: the pattern of contraceptive use and the rates of UP were derived from published sources. The costs of UP in the United States and the proportion of total cost that might be avoided by improved adherence through increased use of LARC were estimated. ResultsAnnual medical costs of UP in the United States were estimated to be $4.6 billion, and 53% of these were attributed to imperfect contraceptive adherence. If 10% of women aged 20–29 years switched from oral contraception to LARC, total costs would be reduced by $288 million per year. ConclusionsImperfect contraceptive adherence leads to substantial UP and high, avoidable costs. Improved uptake of LARC may generate health care cost savings by reducing contraceptive non-adherence.

Objective Structured Clinical Examination: Contraceptive Counseling for Long Acting Reversible Methods

Abstract As the burden of unintended pregnancy and abortion in the United States now falls disproportionately to poor and uninsured women, appropriate contraceptive counseling requires strong limit...

Family planning and the burden of unintended pregnancies.

Family planning is hailed as one of the great public health achievements of the last century, and worldwide acceptance has risen to three-fifths of exposed couples. In many countries, however, uptake of modern contraception is constrained by limited access and weak service delivery, and the burden of unintended pregnancy is still large. This review focuses on family planning's efficacy in preventing unintended pregnancies and their health burden. The authors first describe an epidemiologic framework for reproductive behavior and pregnancy intendedness and use it to guide the review of 21 recent, individual-level studies of pregnancy intentions, health outcomes, and contraception. They then review population-level studies of family planning's relation to reproductive, maternal, and newborn health benefits. Family planning is documented to prevent mother-child transmission of human immunodeficiency virus, contribute to birth spacing, lower infant mortality risk, and reduce the number of abortions, especially unsafe ones. It is also shown to significantly lower maternal mortality and maternal morbidity associated with unintended pregnancy. Still, a new generation of research is needed to investigate the modest correlation between unintended pregnancy and contraceptive use rates to derive the full health benefits of a proven and cost-effective reproductive technology.

Male Contraceptives on the Horizon

Since the US Food and Drug Administration approved the first hormonal pill for use as a female contraceptive in 1960 the number and variety of female contraceptives has grown considerably. Women now have more than a dozen choices ranging from intrauterine devices improved barrier methods and an array of hormonal contraceptives. Men however currently have just two contraceptive options--condoms and vasectomy. To help close this gap and further reduce the burden of unintended pregnancies worldwide scientists are endeavoring to create new male contraceptive options. So far their results suggest new male contraceptive options may become available within the next decade. Clinical trials are currently under way for several hormonal methods and for at least one contraceptive device. Meanwhile scientists are also probing alternative contraceptive targets. (excerpt)