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  • Title: Low fertility rate in vasovasostomized males and its possible immunologic mechanism.
    Author: Gupta I, Dhawan S, Goel GD, Saha K.
    Journal: Int J Fertil; 1975; 20(3):183-91. PubMed ID: 4400.
    Abstract:
    Contradictory views have been expressed about the role of the various antisperm antibodies which develop after vasoligation. The present study was conducted in 50 normal fertile males, 50 vasectomized subjects and 25 subjects after recanalization of their vas deferens in order to investigate the development of various anti-sperm antibodies after vasectomy, along with their incidence, their persistence after successful relief of vaso-obstruction by vasovasostomy and their role in the causation of infertility in vasoanatomized normospermia males. Sperm agglutinating, immobilizing and haemagglutinating antibodies showed rises in titres with increase during the post-vasectomy period, indicating continuous antigenic stimulus. Age, post-operative complications and blood group did not seem to alter the results. 86% of subjects developed antisperm agglutinins, mostly tail-to-tail type (54.5%), 1-12 years after vasoligation, while only 2% of fertile men had circulating spermagglutinins. A lower incidence of positive sperm in the immobilization test than in the agglutination test suggests either that different antibodies are detected by these two tests or these tests have differing sensitivities. Of the 25 vasovasostomized subject, 13 (52%) cases became normospermic and 4 (16%) oligospermic while 8 (32%) remained azoospermics. Except for 3 oligospermic subjects, all had circulating spermagglutinins. Among the 13 normospermic vasovasostomized persons, a significant correlation was found between the titres of circulating antisperm agglutinins and autoagglutination of spermatozoa in their ejaculates; and also between the sperm immobilization values of their sera and the degree of their sperm motility. Three normospermic recanalized men, having low levels of sperm agglutinins and haemagglutinins with normal seminogram and no sperm immobilizing antibody, successfully impregnated their wives. Another 10 vasovasotomized infertile subjects had sperm agglutinins in significant titre; 5 showed positive sperm immobilization values, a similar number showed autoagglutination of sperm, while a decreased degree of motility of sperms was noted in 6 cases. Thus there was a significant correlation between the titres of anti-sperm antibodies and autoagglutination of spermatozoa, which might be an important cause of male infertility after successful anatomic relief of vasoobstruction. Histological studies of testicular biopsy showed normal spermatogenesis in azoospermic recanalized subjects, although they had high levels of antisperm antibodies. This suggests that these antibodies do not affect normal spermatogenesis, and sperm counts. A study was undertaken in light of the contradictory views concerning the role of various antisperm antibodies which develop following vasoligation. 50 normal fertile males, 50 vasectomized males, and 25 males with recanalized vas deferens were observed. Sperm agglutinating, immobilizing, and hemagglutinating antibodies showed rises in titers with increase during the postvasectomy period indicating continuous antigenic stimulus. 86% of subjects developed antisperm agglutinins 1-12 years after vasoligation while only 2% of fertile men had circulating spermagglutinins. Of the 25 vasovasostomized subjects 13 (52%) became normospermic and 4(16%) oligospermic while 32% remained azoospermic. All had circulating spermagglutinins except for 3 with oli gospermia. A significant correlation was found between the titers of ci rculating antisperm agglutinins and autoagglutinin of spermatozoa in their ejaculates and between sperm immobilization values of their sera and the degree of sperm motility among the 13 normospermic vasovasostomized subjects. 3 normospermic recanalized men successfully impregnated their wives. 10 vasovasostomized infertile subjects had sperm agglutinins in significant titers; 5 had positive sperm immobilization values; a similar number showed autoagglutination of sperm and 6 had a decreased degree of sperm motility. Histological studies of testicular biopsy showing normal spermatogenesis in azoospermic recanalized subjects despite high levels of antisperm antibodies suggest that these antibodies fail to affect normal spermatogenesis and sperm counts.
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