Contraception and Birth Control Research Activities and Advances

NICHD has long been a source of funding for and expertise on contraception research. Extramurally, this expertise and support is led by what is now the Contraception Research Branch (CRB), although it has had slightly different names over the years. For some time, the CRB has focused on supporting and conducting research in contraceptive discovery and development, including dual-use methods that prevent both pregnancy and sexually transmitted diseases (STDs). The Branch is the largest source of support for research on contraceptive development within the federal government. It has responsibility for discovery, development, and evaluation of contraceptive agents.

The CRB uses a combination of grants and contracts to support and/or conduct activities including (but not limited to):

• Phase I, II, III, or IV clinical trials to evaluate the safety and efficacy of new contraceptive methods for women and men
• Research to develop methods for male contraception, including hormonal and nonhormonal control of sperm production and/or sperm function
• Basic and translational contraceptive research and development that may lead to new hormonal or nonhormonal methods for inhibiting ovulation or fertilization
• Experimental studies in animals to determine the safety and efficacy of novel potential contraceptive agents
• Research to define optimal formulations and dosages of contraceptive agents, spermicidal microbicides, and therapies (in animals and humans)
• Projects, as appropriate, on health effects related to contraceptive use and its relationship with other health issues, such as cancer
• Expertise about contraception and contraceptives that contributes to discussions, reports, and evidence-based recommendations, including those of the Cochrane Collaboration and the World Health Organization

The CRB addresses many of these research topics through cooperative agreements with research centers and research networks. These collaborative approaches are described in the Other Activities and Advances section.

Other extramural Branches—such as the Population Dynamics Branch (PDB), the Fertility and Infertility (FI) Branch, and the Gynecologic Health and Disease Branch (GHDB)—study different aspects of contraception, but not development or testing of contraceptive agents. For example:

• PDB funds research on demographic, social, and behavioral aspects of sexual behaviors and their relationship to contraceptive use and non-use in both domestic and international populations. These efforts include studies of the determinants and consequences of contraceptive use in men and women, and basic and interventional research on the sexual transmission of HIV and other STDs. A particular focus of Branch-funded research is the interrelationships among pregnancy, pregnancy prevention, and prevention of STDs.
• The FI Branch supports research to alleviate human infertility, uncover new possible pathways to control fertility, and expand fundamental knowledge of processes that underlie human reproduction. Within this context, the FI Branch studies molecular and basic mechanisms of reproductive processes as a way to regulate fertility.
• GHDB supports basic, translational, and clinical research programs related to gynecologic health throughout the reproductive lifespan, starting at puberty and extending through the early menopause. Branch projects include studies to understand and treat gynecological problems, such as endometriosis, uterine fibroids, and heavy menstrual bleeding, including using contraceptive agents in these treatments.

In 2014 to 2015, NICHD convened an expert panel, comprising experts in basic, clinical, and behavioral research and representatives of industry and non-governmental organizations. The panel was charged with assessing the past accomplishments and impact of NICHD's contraceptive research initiatives, the current status of contraception research at and funded by NICHD, and suggestions for future activities and directions in contraception research. Activities of the CRB, PDB, and FI Branch were the focus of the panel's efforts.

The panel presented its findings to the NICHD advisory council in January 2015, and NICHD is in the process of implementing some of the panel's findings and ideas. You can read more about the panel and its findings at Assessment of the Contraceptive Research Activities of the NICHD: Executive Summary (PDF - 138 KB).

The Cell Regulation and Development Affinity Group, part of the Institute's Division of Intramural Research (DIR), investigates the molecular basis of peptide hormone control of gonadal function and is working on research to support the development of a male contraceptive.

As NICHD continues shifting the priorities of its various components, its commitment to supporting and conducting contraception research—including development of new contractive compounds—remains.

• In 1996, NICHD established the Contraceptive Clinical Trials Network (CCTN) to conduct clinical trials of new contraceptive drugs and devices. Sites within the CCTN, funded through the CRB, are chosen based on their capacity to conduct Phase I, II, and III trials for contraceptive drugs and devices. CCTN research includes studies of:
  • The ability of progestin- and testosterone-based topical gels to inhibit sperm production to provide hormonal contraception for men
  • A progesterone receptor modulator, CDB-2914, as an emergency oral contraceptive for women when taken within 72 hours of unprotected intercourse
  • The effectiveness of a new female condom to prevent both pregnancy and STDs
  • Progestin-based compounds that can prevent pregnancy without increasing the risk of blood clots and other venous thromboembolism-type conditions, especially in obese women
  • A progestin- and estradiol-releasing vaginal ring that would be an effective contraceptive without increasing the risk of blood clots and other venous thromboembolism-type conditions, especially in obese women
• Congress mandated the creation of the Contraceptive Development Research Center Program (CDRCP) in 1993 to fund research centers to develop new contraceptive products. The program is supported through the Institute's CRB and currently includes three centers. The CDRCP also serves as a national resource for supporting the career development of young scientists who want to pursue research in fertility regulation. CDRCP research topics include:
  • Developing a male contraceptive that inhibits an enzyme needed to produce sperm
  • Developing a vaginal ring that acts as a contraceptive and also promotes brain health
  • Understanding how egg cells develop and mature and how they are released to be fertilized
  • Developing new delivery methods for contraceptive agents
  • Developing dual-use compounds that protect against sexually transmitted infections and pregnancy
  • Conducting translational research to identify or optimize male contraceptive products
  • Developing nonhormonal contraception methods that inhibit ovulation
• Funded through the CRB, the Preclinical Contraceptive Development Program (PCDP) conducts a wide range of research with the goal of developing useful contraceptive products for men. Research focuses for the program include studies on:
  • How mechanisms regulating sperm maturation might be targeted by novel male contraceptives
  • How sperm development could be inhibited using l targets, such as by disrupting the tight junctions between Sertoli cells and germ cells
  • Testing of injectable form of acyline, a male hormonal contraceptive, to assess safety and ability to suppress spermatogenesis
  • Development of an oral contraceptive for men, H2-gamendazole