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

The purpose of the article is to review the current concepts regarding the etiology and treatment of male-factor infertility. The following general conclusions can be drawn: (a) conventional parameters for sperm quality and male fertility are inadequate and any assessment should involve several different tests of sperm cell function to increase the fertility prognosis; (b) the causes of disturbed sperm quality are still poorly understood; (c) the role of the varicocele is still controversial but some of the discrepancies reported in the literature may be explained by the negative influence of other factors such as smoking, epididymal pathology or glandular infections operating either in conjunction or independent of the varicocele; (d) the role of chronic inflammatory processes in the reproductive organs, in particular the involvement of chronic chlamydial infections, has been underestimated, largely because it is often asymptomatic and difficult to demonstrate objectively; (e) partial androgen insensitivity may account for a significant number of cases of severe oligozoospermia; (f) no major advances have been made in the medical treatment of poor sperm quality; (g) assisted fertilization techniques such as IVF and GIFT offer encouraging possibilities for the treatment of male-factor infertility; and (h) recent advances in microsurgical techniques are increasing the treatment possibilities for certain forms of obstructive azoospermia and severe oligozoospermia.
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PMID:Male infertility: current concepts. 138 88

In view of reports that the human epididymis may play no role in human fertility, literature on the fertilizing capacity of epididymal spermatozoa was reviewed. The survey indicates that under the circumstances of their retrieval, human epididymal and testicular spermatozoa may have the ability to fertilize human eggs both in vivo and in vitro. Although the "fertility profile" of the normal epididymis cannot be explored in man, a fair assumption would be that fertilizing capacity develops fully in the distal part of the tract, judging from the higher motility and egg fusing ability of sperm taken from these regions of unobstructed tissue. Motility and fertilizing capacity observed with IVF or artificial insemination, in which sperm are obtained from obstructed ducts, may occur at a level in the tract more proximal than normal, as in animals. The pregnancies resulting from aspiration of spermatozoa from, or anastomosis of the vas deferens to, the efferent ducts are of great clinical interest, but the pathological state of the tissue precludes definitive statements about the functioning of a normal epididymis. In the former case, the immediate origin of the fertilizing spermatozoon and the nature of the secretions previously bathing it are unknown and in the latter case the time needed before pregnancies occur is much greater than anticipated had fertile sperm been present in the proximal epididymis. The evidence supports neither the view that testicular sperm are inherently fertile nor that a simple aging of sperm cells is sufficient for the fertilizing potential of spermatozoa to be realized. It emphasizes, rather, the importance of the environment to which the sperm cells are subjected. Under abnormal conditions other accessory glands may secrete compounds that are necessary for the maturation of spermatozoa. Before more information is known of the exact situation existing, or having existed, in pathological human tissues from which fertilizing human spermatozoa can be obtained, great caution should be exercised in interpreting the results of pregnancies arising from the in vivo and in vitro insemination of testicular or epididymal spermatozoa.
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PMID:In defense of a function for the human epididymis. 224 54

This case report describes successful IVF of oocytes of a 22-year-old female with epididymal spermatozoa aspirated from alloplastic spermatocele of the husband presenting with bilateral congenital absence of the vas deferens. Motile spermatozoa were aspirated from the reservoir 3 months after implantation. Abortion occurred 22 days after embryo replacement.
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PMID:In vitro fertilization with spermatozoa from alloplastic spermatocele. 231 32

Microsurgical epididymal sperm aspiration (MESA), or sperm microaspiration retrieval technique (SMART), in conjunction with in vitro fertilization is a successful therapy in male infertility. From November 1991 to March 1994 a total of 29 attempts at MESA with subsequent IVF were made. Of 48 aspirations, 37 were successful and 13 attempts at IVF were possible, 6 of which were successful with 10 subsequent embryo transfers. In all, 3 pregnancies were achieved and 1 boy was born. In conclusion, microsurgical spermaspiration in conjunction with in vitro fertilization is a way of treating male infertility with a chance of achieving paternity with the partner's own sperm; the chances are probably better with intracytoplasmatic sperm injection.
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PMID:[MESA (microsurgical epididymal sperm aspiration) and IVF (in vitro fertilization). A therapy concept in treatment of male infertility]. 748 59

This study assessed the effect of progesterone and 17 alpha-hydroxyprogesterone (17 alpha-OH-progesterone) at concentrations of 0.01-10 micrograms/ml, on the acrosome reaction and in vitro fertilizing ability of mouse epididymal spermatozoa. Cumulus masses containing oocytes were cultured in Brinster's medium, to which were added capacitated epididymal spermatozoa which had been incubated in medium with various concentrations of progesterone or 17 alpha-OH-progesterone for 90 min. IVF success rate was assessed 20-24 h following insemination. Progesterone was found to increase the fertilization rate at the 1 microgram/ml and 10 microgram/ml concentrations while lower concentrations had no effect. However, 17 alpha-OH-progesterone failed to show any effect on fertilizing ability. Incubation of epididymal spermatozoa in medium containing 1 microgram/ml and 10 micrograms/ml progesterone significantly increased the acrosome reaction as monitored by a chlortetracycline fluorescence assay. 17 alpha-OH-progesterone, however, failed to show any effect on the acrosome reaction. The results suggest direct effects of progesterone, but not of 17 alpha-OH-progesterone, on fertilization and the acrosome reaction of mouse spermatozoa.
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PMID:In vitro fertilization and the effect of progesterone and 17 alpha-hydroxyprogesterone on acrosome reaction of mouse epididymal spermatozoa. 755 78

Microsurgical epididymal sperm aspiration (MESA) and IVF techniques are indicated in those cases of bilateral congenital absence of the vas deferens (BCAVD) and in cases of epididymal obstruction (EO) of other aetiologies were vasoepididymostomy is not possible or has failed. Microsurgical deferential sperm aspiration (MDSA) is indicated in those cases where spermatogenesis and epididymal permeability are conserved but spermatozoa, for different causes, cannot reach the ejaculate and other therapies have failed. We have performed this procedure in 70 patients by two different human reproduction teams. Both teams achieved very similar results regarding fertilization rate: 5.5 and 7.2% in cases of BCAVD, 6.5 and 8.8% in cases of EO and 33.3 and 26.7% in cases of non-epididymal pathology (NEP). However, the fertilization rate per patient presents differences between both teams: 27 and 44.4% in BCAVD, 31 and 11% in EO and 80 and 100% in NEP. In spite of a better fertilization rate per patient in team two, it was in the other where pregnancies were achieved (7% in BCAVD, 15% in EO and 20% in NEP). One pregnancy in EO group was achieved by intracytoplasmatic sperm injection. The pregnancy rates per transfer were 25% in BCAVD, 50% in EO and 25% in NEP.
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PMID:Critical evaluation of the present experience on microsurgical sperm aspiration. 761 79

We have developed a new sperm collection method by epididymal micropuncture in conjunction with perivascular nerve stimulation to obtain as many uncontaminated spermatozoa as possible for IVF for patients with surgically unreconstructable vasal obstruction. Fifteen azoospermic men with congenital absence of the vas deferens or vasal obstruction not amenable to surgical repair enrolled in this study. Under general anaesthesia the testis and epididymis were retrieved and stabilized in a testicular holder with the aid of 2% agar. The epididymal micropuncture was performed using a micropipette placed in a micromanipulator. A pair of Ag-AgCl ring electrodes were placed around the spermatic cord for perivascular nerve stimulation with DC (intensity 136 V, frequency 20 Hz) for 30 s. Electrical stimulation was repeated every 1 min until no further fluid was obtained. Epididymal fluid obtained ranged from 78 to 980 microliters (mean 169 microliters). Sperm concentration ranged from 0.7 to 200 million (mean 53.5 million). Sperm motility ranged from 0.5% to 70% (mean: 19.9%). The percentage of spermatozoa with normal morphology ranged from 3% to 32% (mean 16.4%). Of 16 cycles in which spermatozoa and oocytes were retrieved, 56% (9/16) resulted in fertilization and 18.8% (3/16) developed clinical pregnancies. The clinical pregnancy rate per couple was 20% (3/15). This is the first clinical experience of the bulk sperm collection system for IVF for the treatment of unreconstructable obstructive azoospermia. Our results indicate that our new technique, in conjunction with IVF, is clinically useful for patients with surgically irreparable vasal obstruction.
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PMID:Bulk sperm collection by epididymal micropuncture and stimulation of the spermatic nerve; a novel method for sperm retrieval for IVF for surgically irreparable vasal obstruction. 766 16

Polychlorinated biphenyls (PCBs) have been reported to adversely affect reproduction in laboratory and wild animals. The present study was undertaken to determine the toxic potential of Aroclor-1254 (A-1254) on in vitro fertilizing ability of oocytes and epididymal sperm and on preimplantation embryo development in the mouse. A-1254 was added to the IVF medium at concentrations of 0.01, 0.1, 1.0, and 10.0 micrograms/mL. Cumulus masses containing the oocytes were obtained from superovulated B6D2F1 mice and were placed in the culture medium containing A-1254 to which epididymal sperm, capacitated in a medium without A-1254, were added. The IVF rate was assessed 20 to 24 h after insemination. A-1254 significantly reduced the mean percent ova fertilized even at 0.1 microgram/mL. Incubation of the cumulus masses in various concentrations of A-1254 for 6 h, followed by insemination with sperm capacitated in the presence of A-1254, also significantly reduced the IVF rate. Capacitation of sperm in A-1254-containing medium, followed by coculture with untreated oocytes, failed to affect the IVF rate. No significant effect on sperm motility was observed following exposure to 1 and 10 micrograms/mL of A-1254. Estradiol-17 beta also reduced the IVF rate, however, the effect of A-1254 was more severe compared to the estradiol treatment. Furthermore, addition of A-1254 to the embryo culture medium was associated with a significant decrease in embryo growth at 48 h and 96 h. These results demonstrate adverse effects of A-1254 on oocytes, IVF, and embryonic development in the mouse.
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PMID:Reproductive toxicity of Aroclor-1254: effects on oocyte, spermatozoa, in vitro fertilization, and embryo development in the mouse. 856 93

Epididymal fine needle aspirations (EFNA) were performed on 29 epididymides of 17 infertile, azoospermic men in whom testicular cytology revealed adequate spermatogenesis. Sonograms confirmed the presence of all the excretory male organs. EFNA was performed to diagnose and locate the site of genital tract occlusion. The presence of cuboidal epithelial cells in the aspirate was the sole indication that epididymal content was aspirated. In 10 (34%) of the 29 aspirates there were only cuboidal epithelial cells and no spermatozoa, indicating proximal occlusion in the rete testis, in the canaliculi efferents or in the most proximal segment of the epididymis itself. Occlusion in the distal segments of the epididymis or in the vas deferens was diagnosed in 13 epididymal aspirates (45%) which contained both cuboidal cells and spermatozoa. In 6 epididymides (21%) no conclusion could be reached because of failed aspirations. There are a variety of treatment modalities available for male genital tract obstruction, such as reconstructive surgery or IVF. The success rate of treatment is mainly dependent on the site of obstruction. Since vasography has its own limitations and hazards, diagnostic EFNA should be performed before treatment in men in whom genital obstruction is suspected.
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PMID:[Epididymal fine needle aspiration replacing vasography]. 795 85

The processes of abnormal sperm penetration and incorporation into human oocytes during IVF and after sperm microinjection, assessed by TEM, are reviewed. A spectrum of morphologically abnormal sperm with head, neck and midpiece defects penetrate the egg vestments of oocytes (1-3 h after insemination with sperm from normal donors) in both unfertilized and normally fertilized oocytes. Sperm with aberrant head shapes, acrosomal and nuclear defects penetrate the outer zona pellucida but are rarely encountered in the inner zona and perivitelline space, showing that the zona prevents abnormal sperm penetration. Grossly abnormal sperm are, however, incorporated into the ooplasm of zona-denuded oocytes. Microinjection of poor-quality sperm from male-factor patients into the perivitelline space or directly into the ooplasm of oocytes also reveals a variety of structural defects conforming to those observed in washed sperm pellets, highlighting the difficulties of selection of 'normal' sperm for microinjection. Abnormal sperm have been seen to interact and fuse with the oocyte in the perivitelline space, and to be incorporated into the ooplasm. Those with nuclear and neck (centriolar) defects are of particular significance, as they might contribute to aberrant development. The functional competence of immotile, round-headed and epididymal sperm is also briefly discussed.
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PMID:Functional competence of abnormal spermatozoa. 805 71


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