Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UNIPROT:P56851 (epididymal)
 11,273 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Our experiences with 343 vaso-epididymal anastomosis operations carried out for the relief of obstructive azoospermia in the past 20 years were reported. The etiologic factors in obstructive azoospermia were discussed. Smallpox was the single most common factor responsible for the obstructive lesion in our series. Obstructive azoospermia due to congenital anomalies was very infrequent. The pathologic physiology of obstructive azoospermia was reviewed. In 37 patients vaso-epididymostomy could not be carried out because of some genital pathology or congenital abnormality. Vaso-epididymal anastomosis was performed in the remaining 281 patients. The operation was succesful in 137 patients (48.75%), and pregnancies occurred in 40 instances (14.23%). However, even after successful operations, the postoperative sperm counts were above 20 million/ml in only 56 patients (19.93%). Persistent necrospermia resistant to treatment was noted in 48 patients (35.04%). In 71 patients (51.83%), spermatozoa appeared in the semen within the first 3 months after operation, but, in 17 patients (12.41%), the appearance of spermatozoa in the semen was delayed for 1 year or more. Twenty patients (7.11%) again became azoospermic after a variable length of time. In this series, bilateral operations were performed on 185 patients and unilateral operations were performed on 96 patients. Our results indicated beyond doubt that bilateral operation is the method of choice. In addition, an analysis of our data showed that operations performed with an internal nylon splint yield more satisfactory results.
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PMID:Vaso-epididymal anastomosis. 115 61

Testicular spermatozoa are functionally immature in that they cannot fertilize ova. It was first demonstrated by Young that spermatozoa undergo certain changes as they migrate through the epididymis. He proposed that spermatozoa ripen during epididymal transit. It is now known that specific maturational changes occur in spermatozoa during epididymal transit which result in their developing the ability to fertilize ova. Concomitant with this functional maturity are changes in spermatozoal morphology, motility, chemistry, permeability, density and metabolism. It is apparent that in some way not understood these changes are necessary for sperm to achieve the ability to complete the fertilization process. When these mechanisms are understood, we may be able to effectively treat conditions such as necrospermia or abnormally low sperm motility. Furthermore, with the development of the hamster-egg penetration test a "new" type of male infertility has become evident in recent years; the inability of otherwise normal sperm to penetrate an ovum. It is during epididymal transit that this ability is normally acquired. Thus, any insight into how sperm attain the capacity to penetrate an ovum could lead to an effective treatment of patients whose sperm do not have this ability. In addition, the epididymis holds significant promise as the site of action for a male contraceptive. Thus, it is the purpose of this review to describe the structure and function of the mammalian epididymis with particular emphasis on the factors regulating sperm maturation.
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PMID:Structure and function of the epididymis. 302 75

Four patients with persistent oligospermia and necrospermia were found to have severely degenerated sperm in the ejaculate. However, in those examined, testicular sperm were ultrastructurally normal, indicating that sperm degeneration and death was occurring during epididymal passage or storage or both or upon mixing with the seminal plasma at ejaculation. Seminal plasma was found to be nontoxic to normal donor sperm. In three patients, frequent ejaculation (two ejaculates per day for 4 or 5 days) was used to deplete epididymal sperm reserves and reduce the period spent in the epididymis. This resulted in a threefold to sevenfold increase in percentage of motile sperm in the ejaculate and a similar increase in sperm motility index. The authors propose the term "epididymal necrospermia" to describe this previously undefined type of male infertility.
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PMID:Human male infertility caused by degeneration and death of sperm in the epididymis. 337 83

Sperm quality and viability can be improved in healthy men with epididymal necrospermia by requesting a second ejaculate 60 minutes after the first specimen is obtained.
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PMID:Clinical management of men producing ejaculates characterized by high levels of dead sperm and altered seminal plasma factors consistent with epididymal necrospermia. 1506 82

This review describes necrospermia, its diagnosis, causes and management. Sperm vitality is commonly assessed in the laboratory of reproductive biology, with the eosin test or with the hypo-osmotic swelling test. Necrospermia is defined by a percentage of living spermatozoa inferior to 58%, and can be related to male infertility. Several pathological mechanisms may be involved and can be classified either in testicular causes (hyperthyroidism, local hyperthermia, varicocele), or post-testicular causes (epididymal necrospermia, dysregulation of seminal plasma, adult polycystic kidney disease, vasectomy reversal, anti-sperm antibodies) or both (infection, toxic, age, spinal cord injury). The first treatment is to correct the underlying cause, if possible. Repetitive ejaculation has demonstrated to be effective as well. Many drugs would also improve the sperm vitality (antioxidants, non-and-steroidal anti-inflammatory drugs) but there is currently no guideline to recommend their use. With necrospermia, fertilization rates are lower but in vitro fertilization (IVF) with Intracytoplasmic sperm injection (ICSI) improves the chances of conception.
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PMID:[Necrozoospermia: From etiologic diagnosis to therapeutic management]. 2869 46