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Query: UNIPROT:P56851 (epididymal)
 11,273 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Infertile men with obstructive azoospermia mainly due to congenital absence of the vas deferens (CAVD) now have the option of trying to father their own progeny. In fact, in the last five years epididymal sperm retrieval microsurgically have been successfully used for in vitro fertilisation of human oocytes. In this report the clinical results of 98 consecutive procedures of microsurgical epididymal sperm aspiration (MESA) combined with in vitro fertilisation (IVF) and tubal embryo transfer (TET) are described. An overall fertilisation rate of 17% and a pregnancy rate of 36% per transfer is reported. Five of the 18 pregnancies resulted in abortion (27%) and 13 were delivered at term. Additionally, extra embryos for freezing and potential use for future attempts were made available for 13 couples. Men with CAVD have also allowed the study of spermatogenesis, immunological response and sperm disposal mechanisms in condition of chronic obstruction.
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PMID:Epididymal sperm in assisted reproductive technology. 130 23

Fructose levels and fructolysis index in human semen were analysed to assess a correlation, if any, between the levels of this glycolysable sugar and sperm concentration. Semen was collected from normospermic men and men with azoospermia or oligospermia. Seminal fructose levels were elevated in men with obstructive azoospermia and in men who remained azoospermic following vasoepididy mostomy done to correct epididymal blockage. Men with sperm concentration of less than 20 million/ml pre-operatively or following vasoepididy mostomy, showed significantly high levels of fructose and lower fructolysis index. Fructose levels in normospermic infertile men, as well as in men with normal sperm counts (more than 20 million/ml), were similar to that in men of proven fertility.
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PMID:Seminal fructose in normal and infertile men. 271 90

Men presenting with azoospermia due to aplasia of the vas deferens have commonly been considered to be infertile without hope of treatment. With improved methods of artificial insemination however, and more particularly with the advent of in vitro fertilization, it has been suggested that unusable spermatozoa may be able to be drawn from the epididymes of such men so that fertilization is achieved. The clinical situation of such men is analogous to that of long term vasectomised patients, 60% of whom are known to produce antibodies to spermatozoa which would interfere with the fertilization process. It was therefore decided to attempt to draw fluid from the epididymes of three such patients and at the same time conduct immunological studies on their sera, seminal fluid and, where available, epididymal fluid. Unfortunately, the spermatozoa obtained from all three men lacked sufficient progressive motility for use in in vitro fertilization. In addition, all men had antispermatozoal antibodies in their sera. Two of them also had antispermatozoal antibodies in their epididymal fluid and on their sperm, one at the same titer as in his serum. Since it is known that antibodies coating sperm reduce the changes of fertilization it is suggested that their presence should be assessed in all such men being considered for treatment. In addition, these studies demonstrate that antispermatozoal antibodies can enter the male tract at the level of the epididymis or higher and there were strong suggestions of local antibody production at this level in the tract.
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PMID:Antispermatozoal antibodies in three men with infertility due to congenital aplasia of the vasa deferentia. 318 49

Daily spermatozoan production, numbers of epididymal spermatozoa, and transit times of spermatozoa through different regions of the epididymis were determined in 38 men, aged 20-49 or 50-79 yr. Specimens were obtained at autopsy within 24 h of death due to traumatic injury or heart failure. Subjects were in apparent good health prior to death, and death was not preceded by an extended period of hospitalization. Daily spermatozoan production per testis (DSP/T) and numbers of epididymal spermatozoa were determined from counts of maturation-phase spermatids or epididymal spermatozoa in tissue homogenized in a Waring blender. Epididymal transit time was calculated as the number of spermatozoa in a given region of the epididymis or in the entire epididymis divided by DSP/T of the connected testis. Parenchymal weight, spermatozoan production rate, numbers of epididymal spermatozoa, and epididymal transit time were similar (p greater than 0.05) between paired testes or epididymides. Men were divided into four groups on the basis of age and DSP/T. Since there was no (p greater than 0.05) effect of age on epididymal transit time, men in different age groups were combined within their respective group on the basis of DSP/T. In the group with high DSP/T, DSP/g parenchyma was much higher and epididymal transit time was much faster. However, parenchymal weights and numbers of epididymal spermatozoa were similar (p greater than 0.05) between DSP/T groups. The similarity in number of spermatozoa in epididymides of men whose DSP/T differed by threefold is consistent with the inability of the human epididymis to store many spermatozoa when no blockage is present.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Effect of daily spermatozoan production but not age on transit time of spermatozoa through the human epididymis. 320 7

To determine the clinical value of seminal transferrin measurements, transferrin concentrations in seminal plasma were determined by single radial immunodiffusion. Men with various disorders of spermatogenesis had significantly lower mean values than those with normal semen (170 micrograms/ejaculate, s.e.m. = 18.4), oligospermia (40.5 micrograms, s.e.m. = 7.2) or azoospermia due to primary seminiferous tubule failure (65.9 micrograms, s.e.m. = 29.1). In these subjects with patent genital tracts, seminal transferrin was directly correlated with sperm concentration and indirectly correlated with serum FSH levels. Seminal transferrin increased following gonadotrophin treatment of men with gonadotrophin deficiency from 19.6 micrograms (s.e.m. = 5.5) to 108.6 micrograms (s.e.m. = 31.7). Patients with genital tract obstructions also had low levels; vasal agenesis (21.8 micrograms, s.e.m. = 5.6), vasectomy (48.5 micrograms, s.e.m. = 21.0), epididymal obstruction (46.6 micrograms, s.e.m. = 7.1). These results confirm that most seminal transferrin comes from the testes and reflects Sertoli cell function. However, there is a very wide range of transferrin levels in normal semen and a number of normospermic samples have low values similar to those seen with abnormal Sertoli cell function or obstruction. Thus, measurement of seminal transferrin is of limited diagnostic value.
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PMID:Seminal transferrin, an index of Sertoli cell function: is it of clinical value? 374 35

The heterologous oocyte penetration (HOP) test, using zona-free hamster oocytes, was used to assess the fertilising capacity of human spermatozoa. There was good correlation between the ability of ejaculated spermatozoa to penetrate the zona-free hamster oocytes and intact human oocytes. Using epididymal spermatozoa, the HOP test results showed that the ability to penetrate oocytes was acquired during their passage through the epididymis. Applied clinically, the HOP test enables a group of infertile men to be identified with a functional defect of their spermatozoa; these men may not be identified at routine seminal fluid analysis. Men with two negative HOP test results were confirmed as being infertile since their wives, if normal, conceived rapidly when donor spermatozoa were artificially inseminated.
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PMID:Clinical evaluation of the heterologous oocyte penetration (HOP) test. 398 63

Cytoproterone acetate (CPA) type antiandrogens have been found to inhibit all androgen-dependent function (also reproductive ability) in man and male experimental animals. In animals a CPA dose can be established which reduces spermatogenesis but leaves hormone regulation unchanged. It is not possible to selectively affect epididymal sperm maturation. Initial clinical experience with high-dosage CPA therapy for fertility inhibition was gained from patients with sex deviations. Oral administration of 100-300 mg CPA daily caused high degree of oligospermia within a few weeks; whether longterm therapy (1 1/2-2 years) leads to desensitization and subsequent increase of gonadotropins and androgens with recovered fertility has not yet been established. Sex drive is strongly affected by high-dosage therapy, hence not desirable for male fertility control. A World Health Organization study used a low-dosage daily oral CPA intake of 5-20 mg over a period of 12-26 weeks. Men under 30 years of age tolerated this daily use without side effects; men over 35 years complained of diminished libido and potency. These CPA dosages reduced sperm quality to subfertile values; sperm count, shape, and motility were affected but no azoospermia was achieved. In vitro and in vivo sperm migration is strongly affected. All somatic and psychosexual changes are reversible. In contrast to animal studies oral use of 10 mg CPA daily modifies endocrinologic processes in man. There is a decrease in FSH and LH synthesis and release; this demonstrates a stronger gestagen effect than the antiandrogen effect of CPA. There is an even greater reduction in plasma testosterone and dihydrotestosterone levels. CPA also modifies testicular androgen production; changes in spermatogenesis can be attributed to a reduced androgen output and to a ect CPA effect on the tubules. A distinct modification of spermatogenesis and posttesticular sperm maturation processes cannot be demonstrated in the dosage range studied. Current studies do not allow a conclusive evaluation of the applicability of CPA for fertility control in men. Longterm studies with smaller CPA dosages are needed.
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PMID:[Modification of fertility of the male by antiandrogens]. 621 27

We studied 29 men with Young's syndrome, a combination of obstructive azoospermia and chronic sinopulmonary infections. Men with this syndrome have only mildly impaired respiratory function and normal spermatogenesis; the azoospermia is due to obstruction of the epididymis by inspissated secretions. The diagnosis is based on the occurrence of chronic sinopulmonary infections, persistent azoospermia, normal spermatogenesis, and characteristic epididymal findings, as well as exclusion of cystic fibrosis and the immotile-cilia syndrome. The sperm themselves appear to be normal in Young's syndrome. Pregnancies had occurred in five couples; in three paternity was documented by genotyping. Thus, improved microsurgical and medical therapy might restore fertility. We suggest that Young's syndrome has a prevalence comparable to that of Klinefelter's syndrome and is a common cause of both chronic sinopulmonary infection and azoospermia.
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PMID:Young's syndrome. Obstructive azoospermia and chronic sinopulmonary infections. 668 37

Men with congenital bilateral absence of the vas deferens (CBAVD) have been regarded as presenting a mild form of cystic fibrosis (CF). In this article, we report a case of male-factor infertility, in which both partners are carriers of the delta F508 mutation and the male partner has CBAVD. Microsurgical epididymal sperm aspiration (MESA) was performed to obtain spermatozoa; intracytoplasmic sperm injection (ICSI) was carried out on the oocytes since the motility of the spermatozoa was severely impaired; and embryo biopsy and a polymerase chain reaction (PCR) were carried out for preimplantation diagnosis of the CF delta F508 mutation. Single-blastomere analysis was performed and indicated that two embryos were affected (homozygous delta F508) and three embryos were carriers. After transfer of the latter three embryos, a singleton pregnancy was established. At amniocentesis, the delta F508 carrier status of the fetus with a 46, XY karyotype was confirmed. A healthy boy was born and the presence of vasa deferentia, bilaterally, was confirmed. The CF sweat test was also normal. Successful fertilization can be obtained by combination of MESA and ICSI in patients with CBAVD. Preimplantation diagnosis of CF is indicated. Pregnancy and birth of normal children can ensue in such patients.
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PMID:Birth after preimplantation diagnosis of the cystic fibrosis delta F508 mutation by polymerase chain reaction in human embryos resulting from intracytoplasmic sperm injection with epididymal sperm. 766 71

We present a simple technique of epididymal sperm aspiration that uses inexpensive and readily available materials. Men undergoing epididymal reconstruction with vasoepididymostomy or autogenous sperm reservoir had sperm aspiration for cryopreservation. Mean total and total motile sperm per aspirate recovered from 25 men have been 25.1 +/- 4.8 x 10(6) and 4.0 +/- 1.4 x 10(6), respectively. Two ongoing pregnancies have been achieved with intracytoplasmic sperm injection using thawed epididymal sperm. Sperm aspiration and cryopreservation maximize a couple's fertility potential with a single procedure and provide a viable fertility alternative to a second surgical procedure in the event of a primary reconstructive failure.
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PMID:A simplified method of epididymal sperm aspiration. 856 Jun 46


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