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• W2095388906 abstract "The increased popularity of vasectomy since the late 1960s has brought the world total to above 50 million with about 8 million performed in the US with an annual rate of about 500000. Although no increased morbidity from vasectomy has been shown in epidemiologic studies it has been shown that vasectomized men may encounter increased rates of atherosclerosis glomerulonephritis cancer and opportunistic infections. The hypothesis is that antigen components of sperm entering the circulation combine with the antibodies to form circulating immune complexes (CIC). Also half of the vasovasostomized men are reported to be fertile but about 1/3 of the operations are not followed by a pregnancy possibly because of antisperm antibodies. Regarding autoimmunization with spermatozoa the changes that take place in the blocked compartment of the genital tract are an increase in hydrostatic pressure distention of the epididymal tubules and the vas intraluminal phagocytosis nonphagocytic disintegration increased resporption epithelial phagocytosis of sperm and direct extravasation of sperm. The immune system probably reacts to sperm components as to foreign substances. A study of postvasectomy development of antisperm antibodies by the tray agglutination test showed that at 1 month 25% have reacted and after 1 year it is up to 60-70%. Sperm agglutinins have been detected up to 20 years after the operation. Several studies have shown that: 1) serum antibodies to the nuclear protamines develop in about 30% of vasectomized men; 2) an early response with spermagglutinating antibodies is associated with high sperm counts; 3) vasectomy increases diet-induced atherosclerosis; 4) 30% of 47 men studied 3 months postvasectomy were found to have CIC whereas 35 nonvasectomized men and 8 vasectomized 1 year earlier had negative samples; 5) in a study of 156 men examined 2 years postvasectomy 4% had CIC by 1 assay a finding not different than one found in a general population; in general it is not believed that increased levels of CIC are found in vasectomy patients; and 6) no significant increase in neoplasms has been found in vasectomied patients but a minor increase in geitourinary syndromes is found. A group of vasovasostomy patients with an immunologic subfertility factor can be identified on the basis of high serum titers. It is suggested that after 1 year men who have not been found to cause a pregnancy in spite of the presence of sperm should have seminal plasma and serum tested for spermagglutinating antibodies and treatment can include low-dose longterm steroids intermittent high dose steroids levamizole treatment semen dilution and sperm wash intrauterine insemination and in vitro fertilization and embryo transfer." @default.
• W2095388906 created "2016-06-24" @default.
• W2095388906 creator A5084558954 @default.
• W2095388906 date "1983-08-01" @default.
• W2095388906 modified "2023-10-05" @default.
• W2095388906 title "Clinical immunology of vasectomy and vasovasostomy" @default.
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• W2095388906 doi "https://doi.org/10.1016/0090-4295(83)90487-9" @default.
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