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Doroftei B, Ilie OD, Maftei R, Scripcariu IS, Armeanu T, Stoian IL, Ilea C. A Narrative Review Discussing Vasectomy-Related Impact upon the Status of Oxidative Stress and Inflammation Biomarkers and Semen Microbiota. J Clin Med 2023; 12:jcm12072671. [PMID: 37048754 PMCID: PMC10095584 DOI: 10.3390/jcm12072671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2023] [Revised: 03/27/2023] [Accepted: 03/31/2023] [Indexed: 04/07/2023] Open
Abstract
Background: Male contraceptive approaches besides tubal sterilization involve vasectomy and represent the method of choice among midlife men in developing countries thanks to many advantages. However, the subsidiary consequences of this intervention are insufficiently explored since the involved mechanisms may offer insight into a much more complex picture. Methods: Thus, in this manuscript, we aimed to reunite all available data by searching three separate academic database(s) (PubMed, Web of Knowledge, and Scopus) published in the past two decades by covering the interval 2000–2023 and using a predefined set of keywords and strings involving “oxidative stress” (OS), “inflammation”, and “semen microbiota” in combination with “humans”, “rats”, and “mice”. Results: By following all evidence that fits in the pre-, post-, and vasectomy reversal (VR) stages, we identified a total of n = 210 studies from which only n = 21 were finally included following two procedures of eligibility evaluation. Conclusions: The topic surrounding this intricate landscape has created debate since the current evidence is contradictory, limited, or does not exist. Starting from this consideration, we argue that further research is mandatory to decipher how a vasectomy might disturb homeostasis.
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Affiliation(s)
- Bogdan Doroftei
- Faculty of Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, University Street no 16, 700115 Iasi, Romania
- Clinical Hospital of Obstetrics and Gynecology “Cuza Voda”, Cuza Voda Street no 34, 700038 Iasi, Romania
- Origyn Fertility Center, Palace Street, no 3C, 700032 Iasi, Romania
| | - Ovidiu-Dumitru Ilie
- Department of Biology, Faculty of Biology, “Alexandru Ioan Cuza” University, Carol I Avenue no 20A, 700505 Iasi, Romania
| | - Radu Maftei
- Faculty of Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, University Street no 16, 700115 Iasi, Romania
- Clinical Hospital of Obstetrics and Gynecology “Cuza Voda”, Cuza Voda Street no 34, 700038 Iasi, Romania
- Origyn Fertility Center, Palace Street, no 3C, 700032 Iasi, Romania
| | - Ioana-Sadyie Scripcariu
- Faculty of Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, University Street no 16, 700115 Iasi, Romania
- Clinical Hospital of Obstetrics and Gynecology “Cuza Voda”, Cuza Voda Street no 34, 700038 Iasi, Romania
| | - Theodora Armeanu
- Faculty of Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, University Street no 16, 700115 Iasi, Romania
- Clinical Hospital of Obstetrics and Gynecology “Cuza Voda”, Cuza Voda Street no 34, 700038 Iasi, Romania
- Origyn Fertility Center, Palace Street, no 3C, 700032 Iasi, Romania
| | - Irina-Liviana Stoian
- Faculty of Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, University Street no 16, 700115 Iasi, Romania
| | - Ciprian Ilea
- Faculty of Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, University Street no 16, 700115 Iasi, Romania
- Clinical Hospital of Obstetrics and Gynecology “Cuza Voda”, Cuza Voda Street no 34, 700038 Iasi, Romania
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Li H, Liu S, Wu S, Li L, Ge R, Cheng CY. Bioactive fragments of laminin and collagen chains: lesson from the testis. Reproduction 2021; 159:R111-R123. [PMID: 31581125 DOI: 10.1530/rep-19-0288] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Accepted: 10/03/2019] [Indexed: 12/11/2022]
Abstract
Recent studies have shown that the testis is producing several biologically active peptides, namely the F5- and the NC1-peptides from laminin-γ3 and collagen α3 (IV) chain, respectively, that promotes blood-testis barrier (BTB) remodeling and also elongated spermatid release at spermiation. Also the LG3/4/5 peptide from laminin-α2 chain promotes BTB integrity which is likely being used for the assembly of a 'new' BTB behind preleptotene spermatocytes under transport at the immunological barrier. These findings thus provide a new opportunity for investigators to better understand the biology of spermatogenesis. Herein, we briefly summarize the recent findings and provide a critical update. We also present a hypothetical model which could serve as the framework for studies in the years to come.
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Affiliation(s)
- Huitao Li
- The Second Affiliated Hospital & Yuying Children's Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China.,The Mary M. Wohlford Laboratory for Male Contraceptive Research, Center for Biomedical Research, Population Council, New York, New York, USA
| | - Shiwen Liu
- The Second Affiliated Hospital & Yuying Children's Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China.,The Mary M. Wohlford Laboratory for Male Contraceptive Research, Center for Biomedical Research, Population Council, New York, New York, USA
| | - Siwen Wu
- The Second Affiliated Hospital & Yuying Children's Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China.,The Mary M. Wohlford Laboratory for Male Contraceptive Research, Center for Biomedical Research, Population Council, New York, New York, USA
| | - Linxi Li
- The Second Affiliated Hospital & Yuying Children's Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China.,The Mary M. Wohlford Laboratory for Male Contraceptive Research, Center for Biomedical Research, Population Council, New York, New York, USA
| | - Renshan Ge
- The Second Affiliated Hospital & Yuying Children's Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - C Yan Cheng
- The Second Affiliated Hospital & Yuying Children's Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China.,The Mary M. Wohlford Laboratory for Male Contraceptive Research, Center for Biomedical Research, Population Council, New York, New York, USA
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3
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Histomorphometric Investigation of Changes In Adult Rat Testis After Experimental Vasectomy At Different Periods. ANADOLU KLINIĞI TIP BILIMLERI DERGISI 2020. [DOI: 10.21673/anadoluklin.666778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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4
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Elhanbly S, El-Saied MA, Fawzy M, El-Refaeey A, Mostafa T. Relationship of paternal age with outcome of percutaneous epididymal sperm aspiration-intracytoplasmic sperm injection, in cases of congenital bilateral absence of the vas deferens. Fertil Steril 2015; 104:602-6. [PMID: 26144574 DOI: 10.1016/j.fertnstert.2015.06.020] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2015] [Revised: 06/02/2015] [Accepted: 06/05/2015] [Indexed: 02/08/2023]
Abstract
OBJECTIVE To assess the relationship between paternal age and the outcome of percutaneous epididymal sperm aspiration-intracytoplasmic sperm injection (ICSI) in patients with congenital bilateral absence of the vas deferens (CBAVD). DESIGN Prospective cohort study. SETTING In vitro fertilization centers. PATIENT(S) Eighty-five (male) CBAVD patients who underwent percutaneous epididymal sperm aspiration with ICSI were divided into 3 age groups; <30 years (n = 27); aged 30-40 years (n = 32); and aged >40 years (n = 26). INTERVENTION(S) History taking, clinical examination, semen analysis, percutaneous epididymal sperm aspiration with subsequent ICSI. MAIN OUTCOME MEASURE(S) Sperm retrieval, clinical pregnancy, and "take-home baby." RESULT(S) The number of sperm retrieved by percutaneous epididymal sperm aspiration significantly decreased with advancing age in the studied groups (0.63, 0.31, and 0.18 million, respectively), concomitant with significant decreases in the outcomes of clinical pregnancy (55.5%, 43.7%, and 23.1%, respectively) and "take-home baby" (48.1%, 40.6%, and 11.5%, respectively). Male age was significantly negatively correlated with retrieved sperm count, sperm motility, sperm vitality, and normal sperm morphology. Multiple logistic regression, adjusted for confounding factors, with male age, and sperm count obtained using percutaneous epididymal sperm aspiration, was significant. The receiver operating characteristic curve showed that a sperm count of 0.55 million as a cutoff value could predict clinical pregnancy with an accuracy of 77.4%, with 82.9% sensitivity and 62% specificity, and "take-home baby" with an accuracy of 81.7%, with 93.1% sensitivity and 62.5% specificity. CONCLUSION(S) In cases of CBAVD, male age has a negative effect on retrieved-sperm count, motility, vitality, and normal sperm morphology; number of retrieved sperm predicted both clinical pregnancy and "take-home baby" outcomes in subsequent ICSI.
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Affiliation(s)
- Samir Elhanbly
- Department of Andrology, Mansoura University, Mansoura, Egypt
| | | | - Mohamed Fawzy
- Department of Obstetrics & Gynecology, Mansoura University, Mansoura, Egypt
| | | | - Taymour Mostafa
- Department of Andrology & Sexology, Cairo University, Cairo, Egypt.
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5
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Steger K, Slavov M, Failing K, Weidner W, Bergmann M. Effect of Vasectomy on Sperm Nuclear Chromatin Condensation in the Rabbit. ACTA ACUST UNITED AC 2013; 26:289-95. [PMID: 15713836 DOI: 10.1002/j.1939-4640.2005.tb01097.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Histone-to-protamine exchange in haploid spermatids is known to play a central role for male fertility. The present study investigates, for the first time, the effects of vasectomy on the expression of protamines in the rabbit. During normal spermatogenesis, protamine-1 and protamine-2 mRNA were expressed from step 5 round spermatids to step 11 elongated spermatids. In unilaterally vasectomized animals, control testes revealed normal spermatogenesis with normal protamine expression, while vasectomized testes exhibited both normal spermatogenesis and spermatogenic arrest. Some testes with normal spermatogenesis revealed delayed expression of both protamine-1 and protamine-2. Furthermore, multinucleated round spermatids were a regular finding in these testes. In both treated and untreated animals, a higher percentage of spermatozoa from the cauda epididymis had highly condensed chromatin when compared with those from the testis. The percentage of spermatozoa with highly condensed chromatin from testes and epididymides from the vasectomized side of treated animals remained unchanged from controls. As the integrity of nuclear chromatin is important for oocyte fertilization, especially in intracytoplasmic sperm injection (ICSI), where most of the natural selection mechanisms are bypassed, our data add valuable information for the treatment of infertility by ICSI, showing that vasectomy may affect nuclear chromatin integrity of testicular spermatids but not epididymal spermatozoa. Microsurgical epididymal sperm aspiration (MESA), therefore, may be superior to testicular sperm extraction (TESE) in vasectomized patients.
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Affiliation(s)
- Klaus Steger
- Department of Urology and Pediatric Urology, German Research Foundation, Giessen, Germany.
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Long-term reproductive consequences of no-scalpel vasectomy in beagles. JOURNAL OF HUAZHONG UNIVERSITY OF SCIENCE AND TECHNOLOGY. MEDICAL SCIENCES = HUA ZHONG KE JI DA XUE XUE BAO. YI XUE YING DE WEN BAN = HUAZHONG KEJI DAXUE XUEBAO. YIXUE YINGDEWEN BAN 2012; 32:899-905. [PMID: 23271294 DOI: 10.1007/s11596-012-1055-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/26/2011] [Indexed: 10/27/2022]
Abstract
The effects of vasectomy on the reproductive organs in various species are controversial. This study investigated the morphological change and apoptosis of the testis, epididymis, and vas deferens in beagle dogs 12 months after vasectomy. The male beagles were divided into two groups: vasectomized and sham-operated groups (n=5 in each). Histopathological, ultrastructural, and TUNEL evaluation of the changes in the testis, epididymis, and ductus deferens of each animal were conducted 12 months after surgery. The mean lumen diameter, cellular thickness, mean interstitial distance, and lumen area fraction of each seminiferous tubule and ductus epididymis were measured by stereological analysis. The results showed that, compared with the sham-operated group, the seminiferous tubular epithelial cells of the testes in the vasectomized group were disorderly arranged and scattered. Significant atrophy and apoptosis were found in the endothelial cells, and a range of ultrastructural variations were observed in the cells of testes, epididymis, and vas deferens in vasectomized group. It was concluded that complete obstruction of the vas deferens as a traditional contraception method is not absolutely safe in terms of the reversal of fertility in the long run. Techniques of relieving the inner pressure in the vas deferens while maintaining the efficacy of male contraception need to be explored.
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Azmy AM, Abd Allah MA, Mohamed DA. Effect of unilateral obstruction of vas deferens on ipsilateral epididymis of adult albino rats. THE EGYPTIAN JOURNAL OF HISTOLOGY 2012; 35:840-852. [DOI: 10.1097/01.ehx.0000421521.12984.55] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
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8
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Contuk G, Orun O, Demiralp-Ekşioğlu E, Ercan F. Morphological alterations and distribution of occludin in rat testes after bilateral vasectomy. Acta Histochem 2012; 114:244-51. [PMID: 21764426 DOI: 10.1016/j.acthis.2011.06.006] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2011] [Revised: 05/18/2011] [Accepted: 05/19/2011] [Indexed: 11/17/2022]
Abstract
The aim of study was to investigate the fate and the morphology of the cells which constitute the spermatogenic line, and to determine the distribution of occludin in the testis in adult vasectomized Wistar rats. The rats were divided into two groups: control group (sham-operated) and vasectomized group. One, 3 and 6 months after sham and vasectomy operations, testis samples were examined. The weight of the testes was found to be reduced 3 and 6 months after vasectomy. There was vacuolization in the seminiferous tubules one month after vasectomy. The tubules showed severe atrophy 3 and 6 months after vasectomy. The occludin immunolabeling in the 3- and 6-month groups was weak and diffuse, and the density of the protein was found to be decreased. The increase in the number of apoptotic cells was accompanied by a time-dependent decrease in the number of haploid, diploid and tetraploid cells. This study demonstrated that vasectomy causes degeneration in the seminiferous tubules with alterations in occludin distribution with a decrease in the number of spermatogenic cells. Moreover, these alterations increase in a time-dependent manner.
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Affiliation(s)
- Gazi Contuk
- Department of Histology and Embryology, School of Medicine, Marmara University, Istanbul, Turkey
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Başar MM, Kisa Ü, Tuğlu D, Yilmaz E, Başar H, Çağlayan O, Batislam E. Testicular nitric oxide and thiobarbituric acid reactive substances levels in obstructive azoospermia: a possible role in pathophysiology of infertility. Mediators Inflamm 2006; 2006:27458. [PMID: 16951488 PMCID: PMC1592597 DOI: 10.1155/mi/2006/27458] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Objective. The aim of the study is to evaluate the levels
of nitrite/nitrate and thiobarbituric acid reactive substances
(TBARS) and their relationship with seminal parameters in
experimental obstructive azoospermic rats to explain the possible
mechanism of impaired sperm quality in obstructive azoospermia.
Methods. A total of 10 male Spraque-Dawley rats underwent
bilateral vas resection and ligation
(Group-1 = vasectomy group). The findings were
compared with control group (Group-2 = sham group,
n = 10). Animals were sacrificed 8 weeks after surgery. Testes
were removed and used for the evaluation of nitrate/nitrite and
TBARS levels and for histology. Epididymal-aspirated
seminal plasma was used for semen count and morphological analysis
according to the Kruger criteria. Results. Testicular
tissue nitrate/nitrite and TBARS levels were 35.7 ± 3.1 μmol/g protein
and 3.7 ± 0.1 nmol/g protein in
Group-1, and 19.3 ± 0.7 μmol/g protein and
3.1 ± 0.1 nmol/g protein in Group-2, respectively. Both parameters
showed statistical differences between the two groups.
Testicular tissue nitrate/nitrite and TBARS levels showed negative
and statistically significant correlations with sperm motility and
morphology. Conclusions. The present study showed that
testicular nitrate/nitrite and TBARS levels were increased in
obstructive azoospermia. For that reason, we concluded that
antioxidant treatment can be recommended to patients before sperm
extraction for artificial reproduction due to obstructive
infertility after vasectomy reversal.
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Affiliation(s)
- M. Murad Başar
- Department of Urology, Faculty of Medicine,
University of Kırıkkale, 71100
Kırıkkale, Turkey
- *M. Murad Başar:
| | - Üçler Kisa
- Department of Clinical Biochemistry, Faculty of
Medicine,University of Kırıkkale, 71100
Kırıkkale, Turkey
| | - Devrim Tuğlu
- Department of Urology, Faculty of Medicine,
University of Kırıkkale, 71100
Kırıkkale, Turkey
| | - Erdal Yilmaz
- Department of Urology, Faculty of Medicine,
University of Kırıkkale, 71100
Kırıkkale, Turkey
| | - Halil Başar
- Department of Urology, Faculty of Medicine,
University of Kırıkkale, 71100
Kırıkkale, Turkey
| | - Osman Çağlayan
- Department of Clinical Biochemistry, Faculty of
Medicine,University of Kırıkkale, 71100
Kırıkkale, Turkey
| | - Ertan Batislam
- Department of Urology, Faculty of Medicine,
University of Kırıkkale, 71100
Kırıkkale, Turkey
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Ramos L, Wetzels AMM, Hendriks JCM, Hulsbergen-van de Kaa CA, Sweep CGJ, Kremer JA, Braat DDM, Meuleman EJH. Percutaneous epididymal sperm aspiration: a diagnostic tool for the prediction of complete spermatogenesis. Reprod Biomed Online 2004; 8:657-63. [PMID: 15169581 DOI: 10.1016/s1472-6483(10)61646-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
The classification of azoospermia into obstructive or non-obstructive is largely based on medical history, physical examination and biochemical markers in serum and semen. However, the most accurate parameter for diagnosis is the testicular histology. The predictive value of the percutaneous epididymal sperm aspiration (PESA), FSH, LH, testosterone, inhibin-B and testicular volume was investigated for their accuracy to predict a complete spermatogenesis (Johnsen score > or =8) in order to replace the testicular histology. The specificity and sensitivity of FSH, inhibin-B, LH, testosterone, testicular volume, and the presence of sperm in a PESA procedure was evaluated in 147 azoospermic males attending the centre for infertility diagnosis. A positive PESA outcome presented the highest sensitivity and specificity to predict a Johnsen score > or =8 (93 and 94% respectively) compared with FSH (90 and 19%), inhibin-B (88 and 57%) and testicular volume (95 and 45%). Differences in clinical presentation were observed between patients with positive sperm retrieval with PESA, depending on the aetiology of obstruction. In conclusion, the presence of spermatozoa in the epididymis (PESA+) correlates with a Johnsen score > or =8 and is the most accurate parameter to predict complete spermatogenesis compared with clinical or biochemical parameters. Between obstructive azoospermic patients, the clinical parameters observed varied according to the aetiology.
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Affiliation(s)
- L Ramos
- Department of Obstetrics and Gynaecology, Division of Reproductive Medicine, University Medical Centre Nijmegen, Geert Grooteplein 8, PO Box 9101, 6500 HB Nijmegen, The Netherlands.
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11
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Mishra PK, Manivannan B, Pathak N, Sriram S, Bhande SS, Panneerdoss S, Lohiya NK. Status of spermatogenesis and sperm parameters in langur monkeys following long-term vas occlusion with styrene maleic anhydride. JOURNAL OF ANDROLOGY 2003; 24:501-9. [PMID: 12826690 DOI: 10.1002/j.1939-4640.2003.tb02702.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Vas occlusion by styrene maleic anhydride (SMA), trade name RISUG (one of the promising male contraceptive procedures currently in phase III clinical trials), at 60 mg/vas deferens dissolved in 120 micro L dimethyl sulphoxide (DMSO) at up to a 540-day study period caused severe oligospermia in the first 2 to 3 ejaculations and uniform azoospermia in the subsequent ejaculations without toxicity in langur monkeys. The ejaculated spermatozoa were necroasthenoteratozoospermic, suggesting instant sterility. Routine hematology and clinical chemistry parameters and the serum testosterone and sperm antibody titers remained unchanged from their pretreatment values until 540 days vas occlusion. Histology of testes revealed continued spermatogenesis throughout the study period. The stages of spermatogenesis appeared normal until 300 days of vas occlusion. At 360 days of vas occlusion, germ cells appeared in the lumen. Degeneration of seminiferous epithelium was evident in some of the tubules. Following 420 days of vas occlusion, the central portion of the testis showed regressed seminiferous tubules depicting various shapes and devoid of germ cells, which continued until 540 days of vas occlusion. Ultrastructure of the testes after 540 days of vas occlusion revealed vacuolization in the cytoplasm of Sertoli cells and degenerative features in the membranes of the spermatocytes and spermatids in the affected seminiferous tubules. The sub-cellular features of the normal tubules were similar to those of controls. The results suggest focal degeneration of seminiferous epithelium in the central portion of the testis following long-term vas occlusion with SMA.
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Affiliation(s)
- Pradyumna K Mishra
- Reproductive Physiology Section, Department of Zoology, University of Rajasthan, Jaipur, India
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Whyte J, Cisneros AI, Rubio E, Whyte A, Mazo R, Torres A, Sarrat R. Morphometric study of testis of Wistar rat after open-ended vasectomy. Clin Anat 2002; 15:335-9. [PMID: 12203376 DOI: 10.1002/ca.10051] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
The effects on the testis of open-ended vasectomy in the Wistar rat have been assessed morphometrically and evaluated statistically at 1, 4, 12, and 24 weeks after operation, and compared to those in sham-operated controls. The open-ended technique, ie, without ligation of the epididymal end of the cut ductus deferens, allowed drainage of sperm into the spermatic cord. During the period of our study, it did not affect the structure of the testis; although the germinal epithelium, basement membrane, and the stroma and cells of the interstitial space all showed variations when compared to the control group, these were not statistically significant.
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Affiliation(s)
- J Whyte
- Department of Human Anatomy and Histology, School of Medicine, University of Zaragoza, Zaragoza, Spain.
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13
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Abstract
Vasectomy is regarded as the safest method now available for male fertility control. Almost 100 million men worldwide have relied on vasectomy for family planning. This review discusses all currently relevant operative techniques, including no-scalpel vasectomy, complications, possible long-term effects on the testis and epididymis, and diseases for which associations with vasectomy have been suggested, such as arteriosclerosis, autoimmune diseases and cancer of the prostate and testis. Other topics of discussion include the timing of post-operative semen analysis, patient noncompliance concerning post-operative controls, persistent cryptozoospermia and transient reappearance of spermatozoa after vasectomy, vasectomy failure and legal aspects.
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14
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Abstract
A number of cell populations in the reproductive tract show a response to vasectomy. Some cell types show similar responses in man and all laboratory species, whereas others show marked species variations. This chapter describes these effects in a broadly chronological order and, in a general way, considers changes close to the site of vasectomy first and the longer term effects on the testis itself later. Following vasectomy, epididymal distension and sperm granuloma formation result from raised intraluminal pressure. The sperm granuloma is a dynamic structure and a site of much spermatozoal phagocytosis by its macrophage population. In many species, spermatozoa in the obstructed ducts are destroyed by intraluminal macrophages, and degradation products, rather than whole sperm, are absorbed by the epididymal epithelium. Humoral immunity against spermatozoal antigens following vasectomy is well established and there is evidence of modest T-lymphocyte activity. The role of lymphocytes in the reproductive tract epithelium and interstitium following vasectomy is poorly defined. In laboratory animals, there is evidence that pressure-mediated damage to the seminiferous epithelium can follow sperm granuloma formation and obstruction in the epididymal head. However, the contribution of lymphocytes and antisperm antibodies to testicular damage after vasectomy is far from clear. A number of studies have suggested that testicular changes may follow vasectomy in man but their validity and mechanism of occurrence require further study.
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Affiliation(s)
- S W McDonald
- Laboratory of Human Anatomy, University of Glasgow, Scotland
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