Journal Article

Impaired spermatogenesis in men with congenital absence of the vas deferens

Maxwell V. Meng, Lauri D. Black, Imok Cha, Britt-Marie Ljung, Renee A.Reijo Pera and Paul J. Turek

in Human Reproduction

Published on behalf of European Society of Human Reproduction and Embryology

Volume 16, issue 3, pages 529-533
Published in print March 2001 | ISSN: 0268-1161
Published online March 2001 | e-ISSN: 1460-2350 | DOI: https://dx.doi.org/10.1093/humrep/16.3.529
Impaired spermatogenesis in men with congenital absence of the vas deferens

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It is generally assumed that men with congenital bilateral absence of the vas deferens (CBAVD) have azoospermia because of obstruction and that sperm production is normal. This study examines spermatogenesis in men with CBAVD to assess the validity of this assumption. We identified all men with CBAVD who had undergone either a diagnostic or therapeutic fertility procedure. Procedures included diagnostic biopsy, testis fine needle aspiration (FNA) mapping, microscopic epididymal sperm aspiration (MESA), and testis sperm extraction (TESE). Among 33 CBAVD men, 18 underwent testis biopsy, 27 had MESA/TESE, and 10 had FNA mapping. On evaluation of these procedures, normal spermatogenesis was present in 29 men. Four men (12%) demonstrated impaired spermatogenesis. One patient had FNA testis cytology consistent with late maturation arrest, another demonstrated hypospermatogenesis on biopsy and low sperm yield by MESA, and two patients had pure Sertoli cell only histology on biopsy. Aetiologies for impaired spermatogenesis included varicocele and underlying genetic abnormalities. Although patients with CBAVD are assumed to have normal spermatogenesis and infertility due simply to obstruction, the potential for concomitant defects in sperm production exists. A clinical suspicion of testis failure should prompt further diagnostic evaluation of spermatogenesis prior to sperm retrieval. In addition, genetic counselling should be offered and testing for genetic lesions, including cystic fibrosis gene mutations and/or variants, Y chromosome microdeletions, and karyotype abnormalities, should be considered.

Keywords: azoospermia; histology; infertility; testis; vas deferens

Journal Article.  3416 words. 

Subjects: Reproductive Medicine

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