The contraceptive threshold :
Since 2007, the contraceptive threshold has been defined as a sperm concentration of less than 1 million/ml for all mobility types combined. Below this level, you are considered on contraception.
Contraceptive threshold not met:
- If you have not reached the threshold, check if your device is suitable, increase the wear time, and consult a healthcare professional to adjust your approach. Not everyone is equally sensitive to heat; for some, 15 hours is enough, while others may need 17 hours. Schedule a sperm test in 30 days after making these adjustments and continue using another form of contraception in the meantime.
- You can also adjust the type of device, the wear time, and how you distribute it throughout the day. However, in rare cases, this method may not work—sometimes body heat is insufficient or discomfort persists. In such cases, consider switching to another method and contact the Thoreme team for support.
Contraceptive threshold reached :
- Once the sperm test confirms a sperm concentration below 1 million/ml, you can use this method alone if you and your partner agree. Continue wearing your device as usual, and perform a sperm test every three months to ensure effectiveness.
- Maximum duration of 4 years
Currently, there are no clinical trials beyond four consecutive years of use. This does not mean extended use is unsafe, just that there is no scientific data yet. After four years, take a 3 to 6-month break before restarting.
Protocols if you forget to wear your ring:
Daily exposure to body heat is crucial. Mistakes happen, and here are some guidelines based on user experience:
- 1 full day of non-wear per month: Acceptable; just inform your partner.
- 2 full days per month (consecutive or not): Inform your partner, schedule a sperm test in 30 days, and use a secondary contraceptive method until the results confirm contraceptive levels. If sperm concentration is below 1 million/ml, you can return to using only the ring. If it is above, continue using double contraception and schedule another sperm test in one month.
- 3 or more full days per month (consecutive or not): Restart the protocol, schedule a spermogram in two to three months, and use a secondary contraceptive method until the threshold is met.
Note:
- Long-term use
After using the method for four years, take a 3 to 6-month break, and reassess if it is still suitable. Ask yourself whether this method fits your current goals, including your desire for parenthood. Changing your contraceptive method periodically ensures long-term effectiveness and reduces risks.
If you want to completely stop sperm production, wear the device for an additional one to two hours daily, reducing sperm count to the level of a vasectomy.
If you forget to keep your testicles lifted for more than a day, use another contraceptive method for 30 days and schedule a spermogram at the end of that period.
- In case of unplanned pregnancy
The method has many benefits but also comes with risks. Heat affects spermatogenesis at multiple levels, including genetic changes, which are reversible after stopping use. These changes are similar to those caused by chemotherapy or acne treatments.
Here’s what an embryologist from the Centre de Référence sur les Agents Tératogènes (Crat) and the Académie Nationale de Médecine says about the risk:
"Reading the information on sperm DNA in the context of testicular hyperthermia, the possible risk in case of fertilization with an altered sperm is the development of aneuploidy in the embryo. However, this risk is theoretical, as the likelihood of embryos with chromosomal abnormalities developing is low. Similar risks have not been described in other situations with potential aneuploidies, such as paternal chemotherapy. If fertilization occurs during a period when sperm chromosomes are most affected, there is no need to terminate the pregnancy, as the risks are limited. Prenatal diagnosis for chromosomal abnormalities (blood marker tests and early ultrasound at 12 weeks) is sufficient."
"In reading the elements described on spermatic DNA in the context of testicular hyperthermia, the possible risk in case of fertilization with an aneuploid gamete is that of finding this aneuploidy in the product of conception. However, this is a very theoretical risk since the possibilities of development of eggs carrying chromosomal missegregations are very limited. This has not been described for example in other situations where aneuploidies are possible in spermatozoa (paternal chemotherapy). A priori, in this context, if fertilization takes place during the period when sperm chromosomal changes are most marked, there is no reason to propose termination of pregnancy because the risks are very limited. It is only necessary to consider a prenatal diagnosis specifically designed to detect chromosomal abnormalities in numbers (blood marker assays coupled with an early ultrasound at 12 SA), or even an INFP if the result is positive or doubtful."
Here to help:
Your attending physician
Family Planning - CeGIDD - CPEF
The thoreme team
Spermanence every Tuesday night
User committees
The entire ring community
Disclaimer: The information provided in this FAQ is based on user testimonials and is for general information purposes only. It does not constitute medical advice, diagnosis or professional treatment. We are not medical doctors. Always consult a qualified healthcare professional for personalized and appropriate medical advice. We accept no responsibility for any consequences arising from the use of the information provided in this FAQ. Send us an e-mail.
