Adaptations of the male reproductive tract and the fate of spermatozoa following vasectomy in the rabbit, rhesus monkey, hamster and rat

Yohimbine prevents the retrograde flow of spermatozoa into the urinary bladder of dogs induced by xylazine

This study was carried out to determine whether yohimbine antagonizes the retrograde flow of spermatozoa into the urinary bladder of dogs caused by xylazine. Adult dogs were assigned to one of four groups of six dogs each and treated as follows: saline control, xylazine (2.2 mg/kg, i.m.), yohimbine (0.2 mg/kg, i.m.), yohimbine/xylazine (yohimbine, 0.2 mg/kg, i.m., followed 10 min later by xylazine, 2.2 mg/kg, i.m.). Pre- and post-treatment urine were collected by cystocentesis from all dogs. The mean (+/- SD) adjusted total number of spermatozoa in the post-treatment urine of xylazine-treated dogs (141.02 +/- 136.75 x 10(6)) was 15 times higher (P < 0.05) than the number in the post-treatment urine of control dogs (9.16 +/- 20.26 x 10(6), 1763 times higher (P < 0.05) than the number in the urine of yohimbine-treated dogs (0.08 +/- 0.20 x 10(6), and 56 times higher (P < 0.05) than the total number in the post-treatment urine of yohimbine/xylazine-treated dogs (2.54 +/- 4.54 x 10(6)). These results confirm that xylazine induces a significant (P = 0.007) displacement of spermatozoa into the urinary bladder of dogs and demonstrate that pre-treatment with yohimbine prevents this effect.

The post-vasectomy length of the testicular vasal remnant: a predictor of surgical outcome in microscopic vasectomy reversal

To identify another preoperative predictor of surgical outcome in vasal reconstruction, we prospectively measured the post-vasectomy length of the testicular vas deferens from the cauda of the epididymis to the site of the vasectomy in 26 patients undergoing vasal reconstruction. Intraoperatively, the vasal fluid was microscopically inspected and classified as whole sperm present or whole sperm absent. The length of the testicular vasal remnant was correlated with the intraoperative status of the vasal fluid. A testicular vasal remnant length greater than 2.7 cm. predicted the presence of fluid with whole sperm present in 30 of 32 testicles (94%). A testicular vasal length of less than 2.7 cm. predicted the presence of fluid without whole sperm in 17 of 20 testicles (85%). The length of the testicular vasal remnant can be measured preoperatively and knowledge of this length may be used to advise patients regarding the likelihood of successful vasal reconstruction.

Urinary losses of spermatozoa during ejaculation are negligible in boars

Boars that had a catheter implanted surgically in the urinary bladder (n = 10) were used to determine the magnitude of retrograde flow of spermatozoa into the urinary bladder during ejaculation (Experiments 1 and 2) and the post-ejaculatory retention of spermatozoa in the urethra (Experiment 2). The overall mean (+/- SD) total number of spermatozoa in the ejaculates of boars used in Experiments 1 and 2 was 62 +/- 25 x 10(9) and 65 +/- 33 x 10(9), respectively. The overall mean adjusted total number of spermatozoa in the post-ejaculation urine of boars was 106 +/- 537 x 10(6) in Experiment 1, and 41 +/- 242 x 10(6) in Experiment 2. The overall mean percentage of retrograde flow of spermatozoa into the urinary bladder was 0.15 +/- 0.78% for the boars used in Experiment 1, and 0.03 +/- 0.16% for boars used in Experiment 2. In Experiment 2, the overall mean percentage of urethral loss of spermatozoa was 0.45 +/- 1.02%, and the overall mean percentage of total urinary losses was 0.48 +/- 1.03%. These findings demonstrate that in boars, in contrast to bulls, rams, dogs, and cats, urinary losses of spermatozoa during ejaculation are negligible.

Possible biological mechanisms for a relationship between vasectomy and prostatic cancer

Four hypotheses have been reviewed, each of which might serve as a hypothetical biological explanation for a relationship between vasectomy and prostate cancer. The endocrine hypothesis is the only one of these with any firm data to support it, although the majority of the available data does not lend credibility to that theory. The other hypotheses are purely speculative with no hard data to support them. In conclusion, it seems highly unlikely, but not impossible, that there is a biological mechanism supporting a relationship between vasectomy and prostate cancer.

Ultrastructure of epididymal interstitial reactions following vasectomy and vasovasostomy

The response of the male reproductive tract to vasectomy includes inflammation of the interstitial tissue of the epididymis. The pathogenesis of epididymal interstitial reactions and characteristics of the responding cells were studied by electron microscopy in Lewis rats at intervals following bilateral vasectomy, vasectomy followed 1 month later by vasovasostomy, or sham operations. In areas of interstitial reaction, numerous macrophages, monocytes, lymphocytes, neutrophils, and plasma cells occupied the connective tissue. Macrophages, containing many lysosomes and vesicles, aggregated and assumed the appearance of epithelioid cells. Processes of adjacent macrophages interdigitated with one another and closely approached the surfaces of lymphocytes. Many plasma cells with distended rough endoplasmic reticulum appeared in the interstitium. The majority of animals in the vasectomy and vasovasostomy groups exhibited epididymal interstitial changes by 2-3 months; the cauda epididymidis was the region most often affected. The ultrastructural features were indicative of chronic granulomatous inflammation and were consistent with an immune response that includes antigen presentation by macrophages to lymphocytes, lymphocyte differentiation, and local antibody production by plasma cells. The nearly complete absence of sperm or recognizable parts thereof in the interstitial tissue in the areas of the reactions suggests that these lesions formed in response to soluble antigens leaking from the duct. Vasovasostomy was not effective in reversing or retarding epididymal inflammation at the intervals studied.

Vasectomy and spermatic granuloma in hamsters

Fifty-eight hamsters were bilaterally vasectomized either 1, 2, 3 or 6 months before experimentation. Fifty-five sham-vasectomized hamsters served as control. Cauda epididymal fluid was obtained by micropuncture. The effect of vasectomy on the incidence of spermatic granuloma was studied. The data were analyzed according to the presence or absence of granuloma after vasectomy and were compared with the data of their respective control. The incidence of granuloma increased with the duration of vasectomy and reached 92.8% at the end of 6 months after operation. Distension of the epididymis increased to a maximum at 1 month, but recovered to nearly normal irrespective of the existence of granuloma. The weight of the testis, spermatocrit and sperm density significantly decreased, and the percentage of abnormal sperm in the cauda and caput increased markedly in the absence of granuloma compared with their respective tract with granuloma or control. The testes in both the group with and without granuloma showed marked atrophy 6 months after vasectomy. The concentration of carnitine in the cauda epididymal plasma was significantly reduced from 2-6 months. The possible protective effect of a granuloma formation is discussed.

T and B lymphocyte subsets in spermatic granulomas in five rams

Epididymal spermatic granulomas from five adult (greater than 4 years old) rams from a commercial flock were evaluated by quantitative histologic methods. Sections were stained for isotype specific immunoglobulin (Ig)-containing cells or specific lymphocyte subsets, as indicated by plasma membrane staining with monoclonal antibodies (MoAb). For the purpose of analysis, individual spermatic granulomas were allocated to one of three groups (early, resolving, or intermediate) on the basis of histologic examination. Ig-containing cells were most prevalent in early spermatic granulomas, and IgG-containing cells predominated in all spermatic granulomas regardless of their presumed age. IgM immunoglobulin-containing cells were the next in prevalence, and IgA-containing cells were infrequent. Assessment of lymphocyte subsets confirmed that lymphocytes present were of both T- and B-cell lineage and were well represented in all spermatic granulomas. CD4+ (MHC Class II-restricted "helper") T-cells were more prevalent in early spermatic granulomas than in intermediate or resolving types, while CD8+ (MHC Class I-restricted, "cytotoxic/suppressor") T-cells were more prevalent in spermatic granulomas of the intermediate type. These results suggest that in addition to an essentially foreign body reaction to extravasated spermatozoa, both local production of antibody and accumulation of a variety of B- and T-lymphocytes are present in ovine spermatic granulomas.

Early testicular changes after vasectomy and vasovasostomy in Lewis rats

The testes of Lewis rats were studied at intervals from 2 weeks to 3 months after bilateral vasectomy, vasectomy followed 1 month later by vasovasostomy, or sham operations. Aims were to determine the nature of early alterations after vasectomy, and to determine whether vasovasostomy after 1 month would result in reversal of vasectomy-induced changes. Approximately one-fourth of the testes in the vasectomy and vasovasostomy groups displayed histological changes, which consisted mainly of depletion of germ cells. The extent of the depletion varied greatly in different seminiferous tubules. In testes altered in this way, no abnormal infiltrations of lymphocytes, macrophages, or other cells were observed in the seminiferous epithelium or in the interstitium. The rete testis and straight tubules were normal in testes with altered seminiferous epithelium. A few testes in the vasectomy and vasovasostomy groups had necrotic centers. The results suggest that depletion of germ cells occurred as a result of shedding from the seminiferous epithelium into the lumen of the tubules. A cellular immune response, such as occurs in experimental allergic orchitis in other species, did not appear to be responsible for the observed loss of germ cells. This suggests a possible role for humoral antibody in this model, since there is an association between testicular changes and serum antisperm antibodies at longer intervals after vasectomy. Testicular alterations were not reversed by performance of a vasovasostomy 1 month after vasectomy.

Presence and distribution of leucocyte subsets in the murine epididymis after vasectomy

Male mice were vasectomized by 'open-ended' or 'closed' techniques. After 4 weeks the cell-mediated immune reactions were compared with those of sham-operated animals by immunohistochemical localization of leucocytes, using specific monoclonal antibodies. Macrophages and MHC class II antigen-positive cells were the major cell types to appear in all regions of the epididymis after both types of operation. There was recruitment of T-helper/inducer leucocytes but not of T-suppressor-cytotoxic cells. An increased presentation of macrophage-migration inhibiting factor antigen appeared in interstitial and peritubular locations. After 'closed' and 'open-ended' vasectomy granulomata developed in the epididymis. The sperm-containing lumen of these granulomata was invaded by macrophages, MHC class II-positive cells and T-helper/inducer lymphocytes. This mouse model thus reveals a significant epididymal inflammatory response of the epididymis to vasectomy.

Microrecanalization after vasectomy in man

Previously spermatozoa in the semen of vasectomized men were reported in 62 of 63 specimens from 24 men 2 to 31 years postvasectomy (Freund and Couture, 1982). A morphologic basis and term, "microrecanalization," was proposed for this observation. Serial sections (5 mu at 200-mu intervals) of 40 specimens removed at vasovasostomy from 20 men (2 to 14 years postvasectomy) were examined and microcanals (small epithelial-lined channels) were demonstrated in 27 specimens from 18 men. In nine of the 27 specimens, spermatozoa or sperm heads were found within the microcanals. Microcanals occurred in smooth muscle, connective tissue and scar tissue, in each segment, testicular, central and abdominal, in the presence or absence of the vas deferens. Microcanal continuity was traced for 200 to 1140 microns by computerized image analysis. Microrecanalization is characterized by the absence of inflammation or sperm extravasation and is histologically distinct from vasitis nodes or sperm granuloma. Microrecanalization provides morphologic and physiologic bases for the protection of the testis and maintenance of spermatogenesis in man after vasectomy.

Testicular alterations are linked to the presence of elevated antisperm antibodies in Sprague-Dawley rats after vasectomy and vasovasostomy

The relationship between alterations in testicular histology and antisperm antibodies was studied after vasectomy and vasovasostomy in Sprague-Dawley rats, which are immunologically relatively non-responsive to vasectomy. Testes were prepared for histologic study at intervals up to seven months after vasectomy, vasectomy followed three months later by vasovasostomy, or sham operations. Antisperm antibodies were assessed with an ELISA. Testicular alterations, which were observed in a minority of animals after vasovasostomy, consisted mainly of depletion of germ cells. Mean serum antisperm antibody levels were greater for animals with altered testes than for rats with normal testicular histology. In addition, the proportion of rats that showed a positive antisperm antibody response was greater among animals with testicular changes than among those with unaltered testes. When the present results on Sprague-Dawley rats were compared with previous findings on the highly responsive Lewis strain, it was evident that the incidence of testicular changes and the proportion of positive antibody responders were greater in the Lewis strain. However, elevated antisperm antibodies and testicular alterations appeared to be more tightly linked in the less responsive Sprague-Dawley rats.

Effects of cefonicid and other cephalosporin antibiotics on male sexual development in rats

The purpose of this study was to determine whether cefonicid, a cephalosporin antibiotic with a modified N-methylthiotetrazole (MTT) side chain, caused testicular toxicity when subcutaneously administered to Sprague-Dawley male rats from days 6 to 36 postpartum at doses of 50 to 1,000 mg/kg per day. Moxalactam (a cephamycin antibiotic which will be referred to as a cephalosporin for convenience throughout), which contains the MTT side chain, was used as a positive control and was administered at 100 to 1,000 mg/kg per day, and cephalothin, which lacks an MTT side chain, was used as the negative control at 1,000 mg/kg per day. Moxalactam caused a significant reduction in testicular and seminal vesicle weights in 37-day-old animals, and histological examination revealed bilateral multifocal atrophy of the seminiferous tubules at all dose levels. Animals reared to reproductive maturity had significant deficits in fertility, and histological examination revealed multifocal or diffuse atrophy of the seminiferous tubules at all doses with a severity greater than that observed in the 37-day-old animals. The histological findings were confirmed by marked reductions in testicular sperm production rates and cauda epididymal sperm numbers. Cephalothin and cefonicid had no treatment-related adverse effects on the sexual maturation of prepubertal, juvenile, or adult males. The absence (in cephalothin) or modification (in cefonicid) of the MTT side chain was not associated with adverse reproductive effects. The relevance of these findings to humans in prenatal and prepubertal stages of life cannot be determined at this time.

The influence of vasovasostomy on testicular alterations after vasectomy in Lewis rats

The occurrence of alterations in testicular weight and morphology after vasectomy and vasectomy reversal by vasovasostomy was studied in Lewis rats. Animals were studied 3, 4, and 7 months after bilateral vasectomy or a vasectomy followed 3 months later by vasovasostomy. Other rats served as sham-operated controls. The weights of the testes in vasectomy and vasovasostomy animals fell into two groups-small testes weighing less than 0.88 g and normal-sized testes of 1.2 g or more. When the extent of testicular alterations was estimated in sections for light microscopy by use of a semiquantitative testicular biopsy score count (TBSC), the morphology of the testes corresponded closely to the testis weight (r = .94), small testes having correspondingly low TBSC scores. In severely altered small testes, the seminiferous tubules were narrower than in sham-operated rats, and numbers of germ cells were greatly depleted. Many tubules contained only Sertoli cells and spermatogonia, although spermatocytes were present in a minority of tubules. A few seminiferous tubules contained multinucleate spermatids. Electron microscopy of severely altered tubules revealed closely apposed processes of Sertoli cells, which contained filaments, microtubules, and endoplasmic reticulum. In contrast, testes with normal weight in vasectomy and vasovasostomy groups resembled those of the sham-operated animals. Comparison of distributions of testicular biopsy score counts demonstrated differences between vasectomy and vasovasostomy groups as time after operation increased. At the 3-4-month intervals, approximately one-third of the testes were severely altered in both vasectomy and vasovasostomy groups.(ABSTRACT TRUNCATED AT 250 WORDS)

Clinical significance of unilateral testicular obstruction in subfertile males

Unilateral testicular obstruction has been defined by exploratory scrototomy in 80 spontaneously infertile males. The most common sites of obstruction were either in the tail of the epididymis after previous infection (40 cases) or in the vas deferens due to congenital absence or after previous infection or surgery (24 cases). Half of the patients had severe oligozoospermia (less than 5 million/ml) and three-quarters had developed antisperm antibodies, often in high titres. Spermatogenesis was shown by testicular biopsy to be normal (Johnsen score-count greater than 8.0) in almost all of the obstructed testes, and serum FSH levels were normal. Following surgical reconstruction, with prednisolone therapy if indicated by high antisperm antibody titres, 19 (32%) of 60 patients with adequate follow-up successfully impregnated their female partners, with the best results occurring in 30 men who started with sperm counts less than 5 million/ml, 12 of whom (40%) were successful. Removal of irreparably blocked testes in 10 men led to profound falls in high antisperm antibody titres, with production of two pregnancies. Unilateral testicular obstruction appears to be a correctable cause of infertility in some human males.

Comparison of the short-term effects of vasoligation and open-ended vasectomy on the reproductive tract of the male rat

Comparison was made between the short term effects of vasoligation and open-ended vasectomy in the rat at 2, 4 and 8 weeks after surgery. Epididymal granulomata were observed in 2/5 and 1/5 rats respectively 2 and 4 weeks after vasoligation. No epididymal granulomata were observed following open-ended vasectomy, providing some support for the suggestion that this procedure may be beneficial in reducing early post operative complications in the epididymis. An unexpected observation in the 2 week open-ended vasectomy group was the finding that in 2 of 5 animals the proximal end of the vas had been temporarily obstructed by overgrowth of a fibromuscular cap. Increased distal cauda epididymidis tubule diameter in these animals suggested an increased intratubular pressure. No sustained differences were seen in the incidence of granulomata or in the response of the testis or epididymis to either vasectomy procedure by 8 weeks. The results suggest, because of the high incidence of granulomata formation following vasoligation in the rat, that by 8 weeks after surgery both vasectomy procedures are equally effective in preventing further damage in the epididymis caused by elevated intraluminal pressures.

The incidence of spermatic granulomas and their relation to testis weight after vasectomy and vasovasostomy in Lewis rats

The occurrence of spermatic granulomas of the vas deferens was studied in Lewis rats at intervals up to 7 months after vasectomy or vasectomy followed 3 months later by vasovasostomy. The incidence of granuloma progressed with time to involve one or both tracts in 100% of vasectomized rats. In addition, the majority of animals developed new granulomas after vasovasostomy, even though fluid flow through the reconnected vas deferens was demonstrated in vitro. When individual tracts were analyzed, the weight of the testis was related to ipsilateral spermatic granuloma formation in both vasectomy and vasovasostomy groups at 3 and 4 months after initial operation. Testes were small in the absence of a granuloma but similar to those of sham-operated rats if a granuloma was present. The possible protective effect of spermatic granuloma formation on the testis is discussed.

Evidence for retrograde flow of spermatozoa into the urinary bladder of bulls during electroejaculation

Spermatozoa were not found in the urine collected from 12 bulls before electroejaculation, whereas spermatozoa were found in the urine collected after electroejaculation. The concentration of spermatozoa in four consecutive samples of urine collected during the first postelectroejaculation micturition did not differ (P > 0.80) within bulls, suggesting that the spermatozoa found in the urine were those that had flowed into the urinary bladder during electroejaculation. The mean percentage of retrograde flow was 21% and ranged from 1 to 50% for the 12 bulls. These findings demonstrate that there was a significant urinary loss of spermatozoa during electroejaculation.

Evaluation of one-hundred open-ended vasectomies

Open-ended vasectomy was performed on one-hundred men. Sixty-three of them showed up for follow-up six months later. Spontaneous recanalisation had occurred in two. Sperm granuloma without orchialgia was found in 14 out of 59 men (23.9%). Twenty-one out of the 63 thought their sex life had improved, while 40 thought it was unchanged; only one man mentioned pain during intercourse since vasectomy.

Quantitative pathologic changes in the human testis after vasectomy. A controlled study

To determine whether there are any deleterious changes in the human testis after vasectomy, we obtained testicular biopsy specimens from 31 healthy men undergoing vasectomy reversal and from 21 healthy, fertile volunteers. Morphometric analyses of these specimens revealed a 100 per cent increase in the thickness of the seminiferous tubular walls (P less than 0.001), a 50 per cent increase in the mean cross-sectional tubular area (P less than 0.001), and a significant reduction in the mean number of Sertoli cells (P less than 0.01) and spermatids (P less than 0.01) per tubular cross section in the post-vasectomy group, as compared with the control group. Focal interstitial fibrosis was observed in 23 per cent of the specimens from the post-vasectomy group and in none from the control group. There was a significant correlation (P less than 0.01) between interstitial fibrosis and infertility in patients who underwent a surgically successful vasectomy reversal (sperm in the ejaculate). None of the other measured characteristics correlated with infertility after vasectomy reversal. We conclude that significant morphologic changes occur in the human testis after vasectomy. The presence of focal interstitial fibrosis was associated with a high incidence of infertility in this series.

A late post-vasectomy syndrome

A group of 20 surgical specimens in 18 patients with a previously unappreciated syndrome of unremitting epididymal pain and induration 5 to 7 years after vasectomy was collected during a 2-year interval. These symptoms uniformly were unresponsive to conservative measures, including empiric antibiotics. Total unilateral or bilateral epididymectomy and partial vasectomy led to complete relief of symptoms, usually within 24 hours. Pathological examination of the specimens revealed features consistent with sequelae of long-standing obstruction. Recognition of this late post-vasectomy syndrome, which represents a major complication of vasectomy, might be expected to increase as cohorts of vasectomized individuals age.

Effects of long- and short-term vasectomy on structural and functional parameters of the rat

The effects of vasectomy were examined by comparing various parameters from sham operated and vasectomized rats that had undergone surgery at 90 days of age and were killed at 190 or 390 days of age. Significant alterations in the vasectomized rats from sham rats included: testicular and epididymal hypertrophy, formation of pathologic vas deferens granulomas, decreased total serum protein, lowered alpha-globulin levels as shown by serum electrophoresis, and increased sperm agglutinin antibody titers. For vasectomized rats, the differential white blood cell count showed increased numbers of neutrophils and large lymphocytes and decreased numbers of small lymphocytes and basophils. Both the number and extent of many vasectomy-induced alterations were greater in long-term vasectomized than in short-term vasectomized rats.

Experimental production of spermatic granuloma in Balb/c mice

The inflammatory reaction to extravasated spermatozoa was studied in mice by subcutaneous injection of small numbers of such cells. Spermatic granulomata developed several days later, probably as a result of the rather indigestible nature of many spermatozoal components. The granulomata persisted for several days before healing started.

Microsurgery for vasectomy reversal and vasoepididymostomy

Accurate microsurgical techniques developed by us have allowed a considerable improvement in success rate for vasectomy reversal, and a better understanding of the pathophysiology of obstruction. This has permitted us also to treat pathologic obstructive azoospermia more effectively.

Spermiophagy in vitro

An in vitro procedure was designed to investigate whether macrophages discriminate between live and dead sperm and between sperm of different donors. In this procedure 1 million murine peritoneal macrophages were allowed to attach to a cover glass, and the resulting monolayer was overlaid with the same number of sperm cells. The spermiophagic index (SPI) was determined by counting sperm heads phagocytized in 100 macrophages after a given exposure time under standard conditions of incubation. The SPI was proportional to the exposure time, and the curve of dynamics leveled off after 5 h of incubation. This study has shown that sperm cells in an in vitro system are avidly phagocytized by macrophages regardless of their origin, live or dead, provided their plasmalemma is preserved. Preliminary observations in female mice did not support the hypothesis that SPI was inversely proportional to the egg fertilization rate.

HUMORAL IMMUNE RESPONSES IN HEALTHY HETEROSEXUAL, HOMOSEXUAL AND VASECTOMIZED MEN AND IN HOMOSEXUAL MEN WITH THE ACQUIRED IMMUNE DEFICIENCY SYNDROME

In homosexual men, the acquired immune deficiency syndrome (AIDS) is associated with sexual promiscuity and the appearance of circulating immune complexes (CICs) and antibodies to spermatozoa which crossreact with lymphoid cells. A comparative study was initiated to determine whether similar humoral responses existed in 38 heterosexual men lacking sperm antibodies, 13 heterosexuals with sperm antibodies, 42 heterosexual vasectomized men, 22 healthy homosexual men, 26 homosexuals with lymphadenopathy and 16 with AIDS or Kaposi's sarcoma (KS). Sperm antibodies were detected in 12% of the vasectomized heterosexual men, 23% of the healthy homosexuals, 35% of the lymphadenopathy patients and 44% of the men with KS-AIDS. IgG reactive with peripheral blood T lymphocytes was present in only 3% of heterosexuals lacking sperm antibody and 5% of vasectomized men. In contrast, 23% of heterosexuals with sperm antibody, 36% of healthy homosexuals, 31% of men with lymphadenopathy and 62% of KS-AIDS patients were positive in this assay. Antibodies to the neutral glycolipid asialo GM1 were found in none of the vasectomized men, 3% of the heterosexuals without and 8% with sperm antibodies, 17% of healthy homosexuals and 38% and 31% in patients with lymphadenopathy or KS-AIDS, respectively. Lastly, the incidence of CICs, determined by the Raji cell assay, was 0% in vasectomized men, 3% in heterosexuals lacking sperm antibody, 31% in heterosexuals with sperm antibody, 69% in healthy homosexuals, 81% in lymphadenopathy patients and 87% in KS-AIDS. In the homosexuals with lymphadenopathy and KS-AIDS, levels of CICs, T cell-reactive IgG and asialo GM1 antibody were positively correlated (p less than 0.01). Sperm antibody levels were negatively correlated (p less than 0.01) with CICs levels and T cell reactive IgG in heterosexuals and lymphadenopathy and KS-AIDS patients. The results demonstrate that vasectomized men do not manifest at all, and that non-vasectomized heterosexuals with sperm antibodies manifest to a much lesser extent the range of humoral immune responses exhibited by the three homosexual groups. Thus, the route of sperm immunization and/or exposure to autologous vs. heterologous spermatozoa may be of critical importance for eliciting specific immune responses.

Studies on prolonged spermatozoa survival in Chiroptera: a morphological examination of storage and clearance of intrauterine and cauda epididymal spermatozoa in the bats Myotis lucifugus and M. velifer

The cauda epididymidis, uterine corpus, and cornua and uterotubal junction of Myotis function to retain and preserve normal spermatozoa throughout hibernation. In none of the sites do spermatozoa show features that might account for their extended viability. Spermatozoa stored in the uterus and epididymis show no special orientation toward the epithelium lining these sites, whereas an intimate relationship is established between some sperm and the epithelial cells of the uterotubal junction which might either account for extended postcoital sperm survival or forecast their removal from further participation. Transmission and scanning electron microscopic observations do not disclose any morphological changes in stored luminal spermatozoa. A low rate of phagocytosis of sperm is evident in the female tract during hibernation. However, spermatozoa are evidently not vulnerable to being removed from the storage sites until spring arousal when ovulation occurs. Both uterotubal epithelial cells and phagocytes appear to be involved in the disposal of spermatozoa in the female, whereas epididymal spermatozoa apparently are primarily voided during urination. A mechanism that delays capacitation must underlie the ability of spermatozoa to survive in the female reproductive tract of the hibernating bat.

Sperm-related antigens, antibodies, and circulating immune complexes in sera of recently vasectomized men

Sera from 35 men were collected before and at timed intervals subsequent to vasectomy and examined for the presence of (a) antibody reactive with human spermatozoa, (b) sperm-related antigen, and (c) circulating immune complexes (CIC). Fewer than 10% of the men examined were ever positive for antisperm antibodies. However, sperm-related antigens were elevated in the sera of 18, 18, and 26% of the mean at 2 wk, 2 mo, and 4 mo postvasectomy, respectively. CIC were detected in the sera of some vasectomized men by three different assays. The CIC in patients' sera were precipitated with polyethylene glycol, dissociated, and the individual CIC components identified by an enzyme-linked immunosorbent assay. Most, but not all, of the CIC contained antigen reactive with antisperm immunoglobulin (Ig)G and some also contained complement components C3 and/or Clq. IgA was identified in some of the CIC positive for IgG and sperm antigen and two men had IgM-containing CIC. Analysis of the CIC by sucrose gradient centrifugation revealed them to be heterogeneous in size.

A re-evaluation of daily sperm output of men

The daily sperm output (DSO) was reevaluated and urinary loss of sperm was determined. Ejaculates were immediately fixed with glutaraldehyde, stored, and homogenized in a blender to produce a cell suspension. The number of sperm per ejaculate was determined by phase-contrast cytometry. Based on the average number of sperm per ejaculate for the last three of five daily ejaculates, the DSO was 166 +/- 29 X 10(6) sperm for nine men aged 26 to 38 years. Two successive daily ejaculates were sufficient to stabilize extragonadal sperm reserves following accumulation or depletion of epididymal sperm. Sperm were found in urine of three men, and less than 2% of their DSO appeared in the 24-hour urine. Few sperm were voided in the urine of men ejaculating daily; however, the DSO exceeds previous estimates.

Immunoglobulin classes, secretory component, and sperm agglutinins in semen after vasovasostomy

The immunoglobulin classes of the sperm-agglutinating antibodies in the seminal fluid and serum from four vasovasostomized men, as well as in operatively obtained testis-epididymis fluid from two of them, were investigated by specific solid-phase absorption of IgG, IgM, and IgA. In two patients the major part of the seminal agglutinins was IgA, and in one IgG, indicating that both local production and diffusion of sperm agglutinins from serum to the testis-epididymis compartment may take place. The total levels of immunoglobulins in seminal fluid generally increased after the operation, and IgM was present in two postvasovasostomy samples. This suggests a pathotopic potentiation effect of the vasectomy on the epithelial lining of the testis-epididymis compartment. Comparison of the results of solid-phase absorption with anti-IgA and anti-secretory component (SC) pointed to the presence of "free" SC in postvasovasostomy seminal fluid.

The fate of sperm after vasectomy in the hamster

Young adult male hamsters were subjected to bilateral vasectomy. The reproductive tracts were studied by light and electron microscopy at intervals up to 1 year after the operation. Sperm continued to be produced, since testicular alterations were focal. Spermatic granulomas were associated with the excurrent ducts of all animals 5 months or 1 year after vasectomy and with those of one of four hamsters 2 weeks after the operation. Phagocytosis of sperm in the lumina of the efferent ducts and proximal parts of the epididymis, and disintegration of membranous components of intraluminal sperm occurred in approximately three-fourths of the animals studied 5 months or more after vasectomy. The results indicate that after vasectomy in the hamster sperm are disposed of by phagocytosis in spermatic granulomas, intraluminal phagocytosis, and dissolution in the lumen of the male ducts, although the latter process may be incomplete.

Daily spermatozoal production and epididymal spermatozoal reserves of the human male

Testicular and epididymal spermatozoal reserves were determined for 11 healthy men, a vasectomized man and 12 other men. For healthy men testis weight (19 testes) averaged 16.9 plus or minus 1.2 gm. and daily spermatozoal production was 4.25 times 10(6) per gm. (range equals 1.4 to 6.3 times 10(6) per gm.). Based on our total sample (23 patients) 67 per cent of the men 20 to 50 years old probably produce between 45 times 10(6) and 207 times 10(6) spermatozoa per day. Daily spermatozoal production was normal in 1 vasectomized man. Epididymal reserves of healthy men totaled 182 times 10(6) spermatozoa per epididymis, of which 26 per cent were in the caput, 23 per cent in the corpus and 52 per cent in the cauda. The interval between any previous ejaculation and death was unknown but we assumed that these values are typical for men copulating or masturbating every 1 to 7 days. Extragonadal spermatozoal reserves totaled approximately 440 times 10(6), of which less than 225 times 10(6) would be available for ejaculation in the ductuli deferentia and caudae epididymides. Transit time of spermatozoa through the caput, corpus and cauda epididymidis was estimated as 0.72, 0.71 and 1.76 days. In a vasectomized man extragonadal reserves totaled 7 times 10(9) spermatozoa or about 75 days of production by the testes. Thus, spermatozoal production in man is much less efficient than in other mammals, the extragonadal reserves of spermatozoa are small and maturation of spermatozoa in the caput plus corpus epididymidis occurs in less than 2 days. In terms of these quantitative characteristics the reproductive capacity of man is considerably less than that of a rhesus monkey.

Open-ended vasectomy, sperm granuloma, and postvasectomy orchialgia

The presence of a sperm granuloma at the vasectomy site prevents epididymal pressure build-up, perforation, and the formation of an epididymal sperm granuloma. It thus enhances reversibility of the vasectomy and lessens the likelihood of epididymal discomfort. In two prospective vasectomy series, a sperm granuloma was intentionally allowed to form by not sealing the testicular end of the vas. The sperm granuloma resulted in no instance of orchialgia, but created a greater risk of spontaneous recanalization. This latter problem could only be solved by more careful sealing of the upper end of the vas. In a separate series of nine patients vasectomized elsewhere and specifically referred to us for chronic and persistent postvasectomy orchialgia, seven had no sperm granuloma at the vasectomy site. Pain in these cases was localized in the epididymis and was relieved by vasovasotomy. Any technique of vasectomy carries a very small risk of orchialgia, whether due to the presence of a sperm granuloma at the vasectomy site or to increased epididymal pressure.

Spermatic granuloma of vas deferens after vasectomy in rhesus monkeys and men: light and electron microscopic study

Spermatic granuloma of the vas deferens is a common complication of vasectomy which has received scant morphologic study. This study investigated the light and electron microscopic structure of such granulomas detected in rhesus monkeys (Macaca mulatta) and man after various modes of vasectomy and postoperative periods. Unilateral experimental vasectomy in monkeys was performed by either silk ligation or clasp occlusion; in 4 of 13 ligated animals and 5 of 5 clasp vasectomized animals granulomas developed at the site of fasectomy. In man, portions of the vas deferens were excised adjacent to the site of vasectomy preparatory to vasovasostomy. Of 5 patients studied, unilateral spermatic granulomas developed in 3. Such granulomas in both monkey and man were characterized by (1) masses of sperm surrounded by epithelioid cells and connective tissue, and (2) multiple epithelial-lined channels which often contained sperm and spermiophages. In both species, fine structural characteristics of the epithelium lining such channels closely resembled those of the principal cells of the normal vas. Spermiophagic cells included macrophages, epithelioid cells, and, in the monkey only, neutrophils. Lymphocytic invasion was a common feature of the human granulomas but was found only occasionally in the monkey granulomas. As a greater number of granulomas are studied in humans and monkeys, it is hoped that the processes underlying granuloma formation and the role of such granulomas in the development of complications after vasectomy will be clarified.

Restoration of fertility after non-obstructive vasectomy in the rabbit

This study was undertaken for the purpose of comparing reversibility following long-term sperm obstruction with that following long-term sperm diversion. The rabbit served as the animal model. Sperm obstruction was produced by transection and ligation of the vasa deferentia near the vasal ampulla; sperm diversion by transection of vasa and anastomosis of afferent limb with urinary bladder. After one year. vasal continuity was reestablished by end-to-end vasovasostomy. Restoration of fertility was more successful after sperm diversion than after sperm obstruction. It is concluded that vasocystostomy in the rabbit is a safe and effective method of male fertility control with greater probability for successful reversal than conventional vasectomy.