Contraception: Freedom from Fear

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years', of contraceptive hormones, placed in a slow-release capsule no more than an inch long and the thickness of a kitchen match, is undergoing tests. Implanted in the arm or buttock, the capsule would provide long-lasting protection—or could be removed if pregnancy were desired.

∙ MORNING-AFTER PILL. For the woman who has intercourse seldom or unpredictably, a one-shot birth-control pill is being developed for use the day afterward. Yale University's Dr. John McLean Morris has given large doses of one of the standard estrogens to more than 100 women for four or five days immediately after unwanted coitus—in many cases from rape or incest. There have been no pregnancies. In the absence of any short-order pregnancy test, no one knows how many there would have been without the medication, and the drug produces severe side effects (bleeding, clotting, nausea) when used this way. But the idea is so attractive that virtually all pharmaceutical manufacturers are pursuing it.

Other contraceptive techniques are farther off—but not beyond possibility. How about a drug that works the way an IUD apparently does, speeding ova through the Fallopian tubes so that they cannot be fertilized, or preventing the implantation of fertilized ova in the uterine wall? Searle's Dr. Thomas P. Carney is searching for a chemical that will serve to activate the specific muscles involved. In his research with infertile women, St. Louis' Dr. William H. Masters noticed that some had cervical mu cus so hostile to sperm that it killed them almost on contact. In normal women, during their "safe" periods, the mucus is so sticky and viscous that it tends to smother spermatozoa. So two lines of research are being followed: 1) to keep a woman's cervical mucus viscous enough to block sperm, and 2) to identify the chemical in Dr. Masters' infertile patients and then use it as a contraceptive.

A male contraceptive seems more remote. On a suggestion from Dr. Rock, who noted that sperm production is prevented by too high a temperature in the testicles, some men have immersed their scrota in water at 130°. Sperm reduction lasted for as long as a month, but did not become effective until at least two weeks after the treatment. The tech nique is not likely to catch on. Los Angeles' Dr. Edward T. Tyler found a male pill that knocked out the sperm after two or three weeks. Trouble was, the drug worked with prison volunteers who had no access to alcohol. Combined with even a single glass of beer, it produced severe vomiting, an intolerable rash, giddiness and stupor.

Female hormones will also suppress a man's sperm production—the present pills do this—but they lower both libido and potency, along with more dangerous side effects. Vaccinating a woman against her husband's sperm, or vaccinating him against his own, has been investigated by Dr. Tyler's biologist brother Albert, with poor results so far.

Despite the impressive progress of the past few years, Dr. Guttmacher complains: "We're still in the horse-and-buggy stage of contraception." Dr. Rock and Dr. Goldzieher have a more funda mental objection to present methods. All, they say, attack the problem from the wrong direction, trying to negate nature during most of a woman's possible average of about 400 menstrual cycles. The ideal would be to

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