A Conversation with Régine Sitruk-Ware

How did you decide on a career in science and in contraceptive development specifically?

Since my years in college, I have wanted to help people and become a medical doctor. During residency, I was fascinated by the field of endocrinology, and realized that reproductive medicine is an important field focused on helping women. At that time, abortion was not legal, and I saw women die from unsafe abortion. This showed me that developing appropriate contraception would be essential to help women and prevent tragedies.

I became knowledgeable in the pharmacology of contraceptive hormones and was able to teach how to tailor hormone use to each woman according to her health status. Because of my knowledge, I was hired by Wayne Bardin in the mid-1980s to join the International Committee for Contraception Research (ICCR), a Population Council Advisory Board in Reproductive Health. I was the first woman to join the ICCR.

Meeting the other members and the Council’s researchers, pioneers who developed effective long-acting methods of contraception, and sharing their passion—to meet the needs of millions of women avoid unwanted pregnancies and decrease maternal mortality—was inspiring.

What excites you about your work?

I like research and discovering new areas for improving reproductive health; developing a product and seeing it reach regulatory approval is a great achievement and reward.

As an example, Annovera®, the one-year vaginal system for female contraception, took many years to develop. It was a great satisfaction in getting FDA approval for the product after so much effort. Being involved in the team working together with NICHD on the most advanced product for male contraception is thrilling because this work will be pathbreaking. I also enjoy teaching younger people. Seeing them grow in their career is a wonderful reward.

You’ve worked at the Center for Biomedical Research at the Population Council for over 20 years. What makes the Council and CBR unique? How has CBR influenced your work?

I enjoy working in research and developing new contraceptive options for men and women. Being hired by the Council to join and create an incredible team that works hard and is passionate about the mission of improving lives has enhanced my achievements in the field of reproductive health.

Real innovation happens when people are allowed to pursue ideas that are not conventional. CBR gave me the opportunity to do that when I discovered that Nestorone®, a progestin, could become a treatment for multiple sclerosis. I worked with a network of neurobiologists who showed Nestorone’s positive effect on myelin regeneration. The Population Council supported this work, allowing me to continue this research even though it was not our usual medical area.

ICCR was established in 1970 to advance pathbreaking contraceptive products. Over the years, ICCR researchers developed Mirena®, Copper T®, Norplant®, Jadelle®, and Annovera®, among others. What is next?

We still need research on new options that can provide more choice and meet needs. Developing new products is challenging due to increasing regulatory hurdles. The ICCR remains a force for triggering innovation and creativity to achieve our mission to improve existing products and initiate novel research areas. The advisory members help to steer the research toward meeting users’ needs. The next product may be the first contraceptive for men!

What have been some defining moments in your career?

I have had a long career and several important moments have defined its course. The first is seeing women die from unsafe abortion and women who are desperate about an unwanted pregnancy. This inspired me to work on developing appropriate contraception. Other moments are when I realized that reproductive endocrinology is a field focused on women’s health and when I joined the ICCR and CBR. Meeting the NICHD members and especially Diana Blithe and developing a wonderful collaboration to focus on helping women and men to lead healthy reproductive lives is also significant—I have had many defining moments!

Are there any publications you are particularly proud of?

Several papers are milestones in my career, including: .

• A review on the pharmacology of progestins that has been cited many times and reprinted by the journal
• A paper on the long-lasting effort to explore the structure activity of Nestorone and show its properties on the brain as no other progestin was studied
• Two major papers on the efficacy and safety of Annovera after leading the team conducting the Phase 3 trial and being part of the team achieving FDA approval for the ring.

Where do you see the future of contraceptive development and reproductive science? Do you have any predictions for our field? How will it be different 20 years from today?

We still need more contraceptive options to meet the unmet needs of millions of women and couples. Improving existing methods and finding new innovative methods with additional health benefits will improve uptake and compliance. It is also time to develop male contraceptives for gender equity and to allow men to take responsibility in controlling their fertility. A better understanding of reproductive biology will allow us to design nonhormonal methods for men and women that may be preferred by individuals who do not want or cannot take hormonal contraception.

In 20 years, I predict that there will be several male contraceptives on the market and getting men to control their fertility would help cut unintended pregnancy possibly in half!

What does winning this award mean to you?

The Lifetime Achievement Award for Family Planning is the result of a career of innovative research and clinical dedication that has freed women from unplanned pregnancy and decreased maternal mortality in countries where young women still die of multiple pregnancies or unsafe abortion.

As a physician seeing patients and as a scientist working to bring new solutions to men and women, my career has been devoted to bringing reproductive choice and justice to women and couples through research designed to develop safer methods of contraception, with additional health benefits. Contraception is the best option to help women and couples reach their desired family size when it’s right for them.

I have been fortunate to work at the Population Council and meet extraordinary people and collaborate with scientists at the Council and at other organizations. I worked hard and passionately to make a difference. This award has kindly recognized this and also reflects the teams I have been so proud to lead and collaborate with.

Do you have any advice for young scholars who hope to work in the biosciences field and especially reproductive health?

Mentoring the next generation to share the passion for our work has been a wonderful reward in itself. My main advice to young scholars is to pursue their passion, work hard, publish their work and not to be discouraged by ups and downs in research. Working to analyze the data and keeping up with the literature will help to find a solution and overcome hurdles. I would also encourage them to be kind, share their knowledge, and become mentors themselves for the future generation!