Congenital absence of the vas deferens: the fertilizing capacity of human epididymal sperm

Article Abstract:

Sperm cells develop within the testes, but until they undergo further maturation, they have not been thought to be capable of fertilizing an egg. This maturation occurs as the sperm moves through the epididymis; after leaving the seminiferous tubules, the sperm then passes through the vas deferens and into urethra. Some men are born without a vas deferens; these men generate sperm in their testes, but their semen contains no sperm. Immature sperm removed from the testes has not been successful in fertilizing eggs. For many years, the prevailing notion was that the maturation process took about 11 days. However, evidence is now accumulating to indicate that this process is more rapid than previously thought. In an attempt to successfully fertilize eggs for 28 childless couples in which the man suffered from congenital absence of the vas deferens, physicians surgically removed sperm from different regions of the epididymis. A total of 352 egg cells were collected from the women for attempted in vitro fertilization. In 21 cases embryos were formed, indicating that sperm obtained in this way is capable of successfully fertilizing eggs. A total of seven women delivered normal infants, which included one set of twins. Sperm from the vasa efferentia that had not yet passed into the epididymis was capable of fertilizing eggs. Furthermore, sperm from the beginning portion of the epididymis was more effective in fertilizing eggs than sperm removed from the more distal portions. If maturation were the most important factor, the sperm from the distant portions of the epididymis should have been more effective. The results of this study not only show that successful fertilization can be achieved with the sperm from men without vas deferens, but that the aging of the sperm may play a more significant role than maturity in determining their ability to fertilize an egg. (Consumer Summary produced by Reliance Medical Information, Inc.)

Care and treatment, Methods, Abnormalities, Infertility, Spermatozoa, Sperm, Fertilization in vitro

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Mutations in the cystic fibrosis gene in patients with congenital absence of the vas deferens

Article Abstract:

Genetic mutations may be involved in male infertility. Patients with congenital bilateral absence of the vas deferens (CBAVD), a form of male sterility, may have the same genetic mutations as cystic fibrosis patients. Mutations in the cystic fibrosis transmembrane conductance regulator (CFTR) gene have been identified in both cystic fibrosis and CBAVD. Researchers found 28 different mutations in 102 CBAVD patients without symptoms of cystic fibrosis. Nineteen patients had two mutations in the CFTR gene, 54 patients had only one mutation, and 29 people had no genetic mutations. Although most CBAVD patients had at least one CFTR mutation, a second mutation may be located elsewhere. Very sensitive organs, such as the vas deferens, may be affected by processes causing no disease in other parts of the body.

Analysis, Genetic aspects, Genetic disorders, Cystic fibrosis

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Ovarian transplantation between monozygotic twins discordant for premature ovarian failure

Article Abstract:

A case of ovarian transplantation between healthy monozygotic twins by means of a simple cortical-graft technique is reported. One of them had premature ovarian failure at the age of 14 years, whereas her sister had normal ovaries and three naturally conceived children.

United Kingdom, Health aspects, Case studies, Children, Child health, Ovaries, Twins, Ovarian transplantation

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