RISUG. It is an acronym that stands for “reversible inhibition of sperm under guidance.” It is a one-shot male birth control method that has proven to be 100% effective, remarkably cheap, totally reversible, and with virtually no serious side effects. There is, however, one minor catch with RISUG…you probably can’t get it.

What is RISUG and How Does It Work?

RISUG is a reversible way to inhibit sperm function for the purpose of preventing conception. The method is the innovation of an Indian scientist named Dr. Sujoy Guha, who has spent the last three decades perfecting the technique. RISUG involves placing a polymer called styrene maleic anhydride (SMA) that is mixed with a solvent called dimethyl sulfoxide (DMSO) inside the vas deferens of the male reproductive system.

At a very basic level, the polymer used in RISUG zaps the negative electrical charge of the sperm as it travels through the vas deferens and makes the sperm incapable of fertilizing an egg. The more complex explanation is that the polymer is an anhydride which hydrolizes when it comes in contact with the water in seminal fluid. As the cyclic group breaks during the hydrolization process, the polymer becomes a positively charged hydride which disrupts the negative charge of the sperm and causes the sperm membranes to rupture and the sperm tails to suffer significant damage. As Dr. Guha explains, “Within an hour, the drugs produce an electrical charge that nullifies the electrical charge of the spermatozoa, preventing it from penetrating the ovum.”

Because the polymer has a high molecular weight, the mixture of SMA and DMSO is not absorbed by the body and is not washed away by seminal fluid as it flows through the vas deferens. Lab tests indicate that the polymer is nontoxic and retains effectiveness over the long-term like a magnet does. The production of sperm and hormone levels remain completely unaffected. A man who has been injected with RISUG will still ejaculate millions of sperm along with other fluid, meaning that the backup pressure that often accompanies vasectomies is not a problem with RISUG. However, the vast majority of the sperm will be wholly impaired by the treatment and will not be able to fertilize an egg.

Image Source: Male Contraception Information Project

How Is RISUG Administered and How Can It Be Reversed?

The RISUG procedure starts out similarly to a vasectomy. The scrotum is injected with a local anesthetic to ensure the patient experiences minimal pain. A small incision is made in the scrotum, and the vas deferens is extracted with thin forceps. Instead of the vas deferens being severed, cauterized, and tied back up at the ends (as is the case in a normal vasectomy), the vas deferens is injected with a syringe containing the clear, gel-like polymer before being tucked back into the scrotum. The steps are repeated on the other side of the scrotum.

As for reversibility, animal studies performed by Dr. Guha and his team demonstrate that the polymer injected into the vas deferens can be flushed out with another injection of DMSO. Normal fertility returns soon after the polymer is taken out in this manner.

Challenges of Making RISUG Commercially Available

So far, RISUG has been proven to work 100% of the time and has not caused any serious adverse reactions in the hundreds of men who have volunteered for clinical trials. Although RISUG has reached late Phase III clinical trials in India, it has done so only after fighting through red tape, skepticism, and failure to catch the interest of corporate partners who are necessary for making RISUG accessible to the general public.

In 1993, the results of RISUG’s first clinical trial were published: all the test subjects who received a threshold dosage level produced no viable sperm. Yet RISUG has been stuck in the Phase II clinical trial area since 2000. Other countries (especially developed western nations with more regulatory oversight) are cautious about approving new contraceptive methods and understandably want to ensure that there will be no birth defects in babies conceived subsequent to the removal of the RISUG polymer.

But even if all the trials prove that RISUG is safe, effective, and reversible without adverse side effects in the long-term, it is possible that RISUG fails to become commercially available because it can’t be the cash cow for manufacturers that the numerous contraceptive options for women have been. While it appeared in 2002 that RISUG would be imminently approved in India, Dr. Guha could not get a single corporate partner to team up with him.  Why not? Pharmaceutical companies want to back products that they can sell more than once, such as birth control pills or Viagra. RISUG lasts a very long time and costs very little money. And like so many things, what is good for the average Joe doesn’t quite align with what is good for big business’ bottom line.

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