Across the United States, unintended pregnancies have long represented a complex public health issue with dire consequences for the health of children and families as a whole. The risks to mental health, socioeconomic challenges, and overall impact on quality of life are well-documented. Despite advances in contraception for individuals with a uterus over the past 75 years, rates of unplanned pregnancies remain stable (40 to 45% in the United States), reflecting the limitations of current contraceptive methods and their side effects (Thirumalai et al., 2020). Among commonly used contraceptive methods, condoms, while effective in preventing sexually transmitted infections (STIs), have limited practical effectiveness in preventing unintended pregnancies. About 15 heterosexual intimate partners out of 100 using condoms for a year experience an unplanned pregnancy according to data from Ameli¹. Other contraceptive approaches, such as a vasectomy, have demonstrated efficacy but are still not feasible for all individuals producing functional sperm. Male hormonal contraceptives, including intra-testicular testosterone injections or intramuscular injections combined with oral progestin, have been studied for their ability to reduce sperm production. However, the outcomes of the former method remain unpredictable, and the latter induces side effects such as weight gain, changes in libido, unstable mood, and acne (Behre et al., 2016; Coviello et al., 2004). Nevertheless, recent advances in male contraception research offer new perspectives. Studies have shown that a significant reduction in sperm count, without necessarily reaching azoospermia (absence of sperm in semen), can be sufficient for effective contraception (Thirumalai et al., 2020). For instance, the combined use of transdermal testosterone (T gel) with progestin has proven to be efficacious without notable side effects observed with other methods (Soufir et al., 2011). The introduction of an effective and well-tolerated male contraception could have a significant impact on public health. Models suggest that in the United States, a reduction of several percentage points (3.5%) in unintended pregnancies could be achieved with just 10% of men using a male contraceptive pill (Dorman et al., 2018). This underscores the importance of continuing research and development in this field to offer a diverse and effective range of contraceptive methods, thus contributing to reproductive health and the well-being of individuals.

¹https://www.ameli.fr/assure/sante/themes/contraception/efficacite-moyens-contraceptifs 

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We use the terms "men" and "women", as well as "male" and "female", in reference to cisgender heterosexual relationships, as these are primarily the terms used in the studies cited. However, we recognize that this terminology inadequately and inequitably characterizes people in sexual relationships likely to result in pregnancy. In addition, the term "male contraception" refers to contraceptive methods developed for cisgender men according to the scientific literature below. However, we are aware that this terminology is not inclusive for people of gender diversity.