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  • Title: Does vasectomy increase the risk of atherosclerosis?
    Author: Clarkson TB, Alexander NJ.
    Journal: J Cardiovasc Med; 1980 Nov 15; 5(11):999-1002. PubMed ID: 12311610.
    Abstract:
    The work that stimulated a series of experiments, conducted to determine the relationship between vasectomy and atherosclerosis in nonhuman primates, is summarized along with results in 2 nonhuman primate species. Attention is directed to the following: immunologic injury and atherosclerosis; immunologic responses to vasectomy; effects of atherogenic diet and vasectomy; and the effects of vasectomy alone. Using rabbits as the animal model, early workers found that inducing both immunologic serum sickness and hyperlipoproteinemia caused more extensive atherosclerosis than did hyperlipoproteinemia alone and that the resulting lesions more closely resembled those of human beings in both morphologic characteristics and anatomic location. The mechanism by which immunologic injury exacerbates atherosclerosis still remains unclear, but studies focusing on injury to the vascular endothelium as an important mechanism in atherogenesis are currently of considerable interest. Sperm agglutination, sperm immobilization, and immunofluorescence have all been used to demonstrate circulating free antisperm antibodies after vasectomy. Such antibodies occur in about 50% of vasectomized men and in vasectomized males of several animal species. It is unclear why circulating free antisperm antibodies have not been found in all vasectomized men and male animals. The development of an antibody response to sperm antigen in vasectomized rhesus monkeys has been shown to correlate with high sperm counts before vasectomy and similar observations have been made in studies of men. Results in nonhuman primate species showed that vasectomized monkeys developed more extensive and severe atherosclerosis than did nonvasectomized monkeys of the same age and dietary history. In 2 species of monkeys, the effect of vasectomy on atherogenesis seemed to be present whether the animals were hyperlipoproteinemic or had plasma lipid concentrations in the normal range. The presumed mechanism of atherosclerosis exacerbation is persistent antibody production after vasectomy in response to sperm antigens. The continuing leakage of soluble sperm antigens favors antigenemia and the development of circulating immune complexes, which in turn damage the vascular endothelium. The exact mechanism remains unclear. The accumulated data to show that vasectomy is a risk factor for atherosclerosis in 2 species of nonhuman primates.
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