Update on programs for achieving Specialist in Blood Banking certification in the United States: 2023.

A person who has achieved the Specialist in Blood Banking (SBB) certification is a medical laboratory scientist who receives advanced training in blood banking and transfusion medicine and has passed an examination given by the American Society for Clinical Pathology. There are several pathways or "eligibility routes" to qualify for the examination to obtain SBB certification, with the most common route involving enrollment in a Commission on Accreditation of Allied Health Education Programs-accredited SBB program. The goal of this study was to compile information about the current accredited SBB programs in the United States and SBB exam statistics for purposes of assessing changes in the programs and detecting trends in SBB exam takers and pass rates. SBB program coordinators were surveyed about qualitative and quantitative aspects of their programs. Current data, changes over time, and nationally available data were tabulated for comparison. This information may be helpful for all medical laboratory scientists interested in considering further studies and certification in blood banking and transfusion medicine.

SpermCheck Fertility, an immunodiagnostic home test that detects normozoospermia and severe oligozoospermia.

BACKGROUND: A simple and inexpensive home sperm test could be of considerable value to couples attempting to conceive and to men curious about their fertility potential. A two-strip lateral flow immunochromatographic diagnostic device that allows men to evaluate their sperm count at low cost in the privacy of their own homes is described. METHODS: The ability of SpermCheck Fertility to predict sperm counts obtained using a hemacytometer procedure based on standard World Health Organization methodology was assessed. Test results obtained by lay users were also compared with those obtained by trained laboratory professionals, and the ease of use of the device was evaluated in consumer studies. RESULTS: A total of 225 semen samples were analyzed in the method comparison, and the performance of SpermCheck Fertility was excellent with over 96% of all samples correctly classified as normozoospermic (> or =2 x 10(7) sperm/ml), oligozoospermic (5 x 10(6)-2 x 10(7) sperm/ml) or severely oligozoospermic (<5 x 10(6) sperm/ml). Consumer studies with 164 lay users demonstrated that SpermCheck Fertility was easy to use. Lay users and laboratory professionals agreed 95% of the time when reading the same test independently. Overall, the correct response rate on a 20-question survey about the test was over 97%. CONCLUSIONS: SpermCheck Fertility is a simple and reliable immunodiagnostic test that can quickly inform men as to whether their sperm count is normal, low or very low. This home test can assist couples in deciding whether to seek comprehensive clinical evaluation of the fertility status of the male partner.

The effects of enucleation on the cytoplasmic membranes of Amoeba proteus.

The dependence of cytoplasmic membranes upon the nucleus was studied by examining enucleated amebae with the electron microscope at intervals up to 1 wk after enucleation. Amebae were cut into two approximately equal parts, and the fine structure of the enucleated portions was compared with that of the nucleated parts and starved whole cells which had been maintained under the same conditions. Golgi bodies were diminished in size 1 day after enucleation and were not detected in cells enucleated for more than 2 days. The endoplasmic reticulum of enucleated cells appeared to increase in amount and underwent changes in its morphology. The sparsely scattered short tubules of granular endoplasmic reticulum present in unmanipulated amebae from stock cultures were replaced in 1-3-day enucleates by long narrow cisternae. In 3-7-day enucleates, similar cisternae of granular endoplasmic reticulum encircled areas of cytoplasm partially or completely. It was estimated that in most cases hundreds of these areas encircled by two rough membranes were formed per enucleated cell. The number of ribosomes studding the surface of the endoplasmic reticulum decreased progressively with time after enucleation. In contrast, the membranes of nucleated parts and starved whole cells did not undergo these changes. The possible identification of membrane-encircled areas as cytolysomes and their mode of formation are considered. Implications of the observations regarding nuclear regulation of the form of the Golgi apparatus and the endoplasmic reticulum are discussed.

The development of Golgi complexes and their dependence upon the nucleus inmebae.

The production of Golgi complexes was investigated in Amoeba proteus by introducing a nucleus into cells that had been enucleated for 5 days. Golgi complexes were not detected in 5 day enucleates, nor were they observed in amebae fixed 15 min after renucleation. Samples taken at longer intervals after the introduction of a nucleus exhibited an increase in the size and abundance of Golgi complexes. Small curved smooth cisternae, some of which were aligned in parallel to form small Golgi complexes, were observed 30 min after the operation. Aggregations of small Golgi complexes increased in number in amebae fixed 1 to 6 hr after renucleation. Golgi complexes of normal size were present 6 hr after the operation and became more abundant in samples fixed 12 hr, and 1, 2, and 3 days after renucleation. The possible participation of the granular endoplasmic reticulum in the development of Golgi complexes was suggested by two observations. First, the Golgi complexes in renucleates contained a dense material similar to the content of the endoplasmic reticulum in enucleates and early renucleates. Second, examples of continuity between the endoplasmic reticulum and Golgi cisternae were present in renucleates. The possibility that Golgi complexes can be produced in the absence of preexisting Golgi complexes is discussed.

In search of red blood cells for alloimmunized patients with sickle cell disease.

Patients with sickle cell disease (SCD) typically require transfusions with RBC components, which exposes them to numerous, possible foreign antigens and potentially causes them to produce an antibody or antibodies to the antigens they lack. As transfusion of these patients increases, the likelihood that they will produce an initial antibody or additional antibodies increases. Once a clinically significant antibody is produced, units of RBCs that lack the associated antigen should be transfused. Often patients with SCD present to transfusion service with numerous antibodies in their serum, making the search for compatible RBCs a challenge. The American Rare Donor Program (ARDP) has been used to search for RBCs to meet transfusion needs of this patient population. Between January 2005 and June 2006, approximately 33 percent of the requests to the ARDP for RBC components were alloimmunized patients with SCD. Of these requests, 94.9 percent were completely or partially filled; requests for r"r", Hy-, and E-, hrS- units of RBCs were among the most difficult to fill. This article will discuss the use and effectiveness of the ARDP and testing laboratories associated with the National Reference Laboratory for Blood Group Serology at the American Red Cross in obtaining compatible RBCs for alloimmunized patients with SCD.

Distribution of intracellular and surface components labeled with mannose-3H in amoebae exposed to the local anesthetic lignocaine.

Following injection with mannose-3H, which is a precursor to cell surface components, amoebae were exposed to the local anesthetic, lignocaine. Electron microscope radioautographs were prepared at intervals between 1 and 24 h after injection, and the distribution of silver grains over various parts of control and treated cells was determined. Control amoebae displayed successive peaks of radioactivity associated with the Golgi apparatus, cell surface, and "fringed" vacuoles. In the presence of lignocaine, incorporation of precursor into the Golgi apparatus and endoplasmic reticulum at the early intervals was inhibited, a result suggesting that glycosylation of surface components diminished. At later times, the proportion of grains associated with the cell surface and fringed vacuoles of treated cells decreased while that over lysosomes increased compared to controls. The changes in patterns of labelling of the Golgi apparatus and cell surface in lignocaine-treated amoebae resembled alterations previously observed in amoebae exposed to a general anesthetic. However, the effects of local and general anesthetic agents on the endoplasmic reticulum, lipid droplets, and lysosomes differed.

Production in Escherichia coli, purification and immunogenicity of acrosomal protein SP-10, a candidate contraceptive vaccine.

The testis-specific human sperm antigen, SP-10, has been designated a 'primary vaccine candidate' by the World Health Organization Taskforce on Contraceptive Vaccines. Molecular cloning and sequencing of the cDNAs coding for human (h) and baboon (b) SP-10 have been reported. To produce large amounts of pure antigen for ongoing studies of the immunogenicity and anti-fertility effects of SP-10, we used an efficient Escherichia coli expression system. The full-length open reading frames for hSP-10 and bSP-10 were placed under the inducible T7 bacteriophage RNA polymerase/promoter system. An in-frame fusion was made such that a His6 stretch was produced at the C terminus of SP-10. Upon induction of gene expression, large amounts of hSP-10 or bSP-10 were synthesized and the recombinant (re-) protein segregated into an insoluble fraction. The protein was then solubilized in 6 M guanidine.HCl and purified by immobilized metal affinity chromatography (IMAC). The yield of purified bSP-10 preparation was approx. 20 micrograms/ml of culture. Immunoreactivity of the purified re-SP-10 with MHS-10, a monoclonal antibody specific to SP-10, and rabbit polyclonal sera raised against SP-10, indicated that the synthesized antigen was suitable for immunization studies. Four female baboons were then immunized with the re-bSP-10 antigen. Immunoblots using pre-immune and immune sera from these animals indicated that all four baboons produced antibodies that reacted with native SP-10 extracted from human sperm in a manner identical to that of MHS-10, the positive control. Immune sera also stained the acrosome region of human and baboon sperm heads by immunofluorescence.(ABSTRACT TRUNCATED AT 250 WORDS)

Biphasic production of antisperm autoantibodies follow vasectomy of the Lewis rat.

Temporal changes in the specificity of post-vasectomy autoantibodies to SDS-PAGE separated sperm antigens were investigated in Lewis rats. Sera were obtained from nine vasectomized animals prior to vasectomy, every two weeks for 14 weeks, and less frequently thereafter, up to 41 weeks. Changes in antisperm autoantibodies over time were assessed by ELISA and western blot assay and compared to antisperm isoantiserum and normal Lewis rat serum. A "biphasic" pattern of autoantibody production over time was observed in a majority of individuals. This pattern was characterized by early phase autoantibodies, produced between 0 and 6 weeks after vasectomy, which bound antigens at the stacking, separating and ionic fronts and by late phase autoantibodies, produced after 4 weeks following vasectomy which bound antigens at 86, 63, 52, 43, 31 and 26 kDa. Previous work suggested that some high molecular weight autoantigens were disulfide-bonded polymers of the polypeptides at 86, 63, and 43 kba (Handley, et al., 1988). Indirect immunofluorescence with monospecific isoantisera to the 86 kDa autoantigen suggested that its corresponding high molecular weight polymer was located in the tail of cauda epididymal spermatozoa. This polymer possessed several characteristics of T cell independent autoantigens. These data show a change in the specificity of autoantibodies produced over time after vasectomy which may reflect a shift from T cell independent to T cell dependent autoantibody production by the Lewis rat.

Localization of post-vasectomy sperm autoantigens in the Lewis rat.

Major rat sperm autoantigens of 86, 63, 43, 28 and 20 kDa are recognized by post-vasectomy and hyperimmunization antisera from the Lewis rat (Handley et al., Biol. Reprod. 39 (1988) 1239-1250). In the present study, affinity purified monospecific isoantibodies to each autoantigen were produced by elution from antigens which had been separated by SDS-PAGE and transferred to nitrocellulose. Western blot analysis confirmed a singular specificity for the 63, 28 and 20 kDa antisera and demonstrated some cross reactivity between the 86 kDa and the 43 kDa antisera. The polyclonal antiserum from which the monospecific antisera were produced stained the entire spermatozoon, while monospecific antibodies bound only to the sperm tail, staining the proximal portion (43 and 28 kDa), a distal domain (63 kDa), or the entire tail (86 kDa). Immunohistochemically stained sections of normal rat testes revealed that the 63, 43 and 28 kDa autoantigens were synchronously expressed in the cytoplasm of spermatids in the apical portions of seminiferous tubules during stages II-VIII in the cycle of the seminiferous epithelium. The 86 kDa autoantigen showed little or no staining in testis sections, implying that this autoantigen appeared on mature sperm following spermiation. These and other data suggest that a highly polymeric structure, possibly within the outer dense fibers of the tail, is a dominant sperm autoimmunogen following vasectomy of the Lewis rat.

Appearance of 'natural' antisperm autoantibodies after sexual maturation of normal Lewis rats.

Serum antisperm antibodies were assessed quantitatively with an ELISA in normal male Lewis rats at intervals between ages 10 and 128 days, spanning the onset of puberty. Antisperm antibodies rose between 56 and 91 days, and were significantly higher in 91- and 128-day old rats than at earlier intervals. The animals underwent normal pubertal development as indicated by increases in weights of the seminal vesicles and ventral prostate. The rise in antisperm antibodies correlated temporally with events in the postnatal development of the male reproductive system, with the increase in antisperm antibodies most closely following the time when spermatozoa reach the epididymis and proximal vas deferens at approximately 56 days. The observation that serum antisperm antibodies increased only after sexual maturation suggests that some differentiation antigens of sperm are processed and presented to the immune system under normal circumstances in this strain. Western blot analysis showed that the sera from normal postpubertal Lewis rats bound several proteins, including bands of > 100, 82-75, 78, 68, 65, 63, 54-55, 42, 37, 35, 26, and 20-22 kDa. The majority of these autoantibodies were sperm-specific as shown by the absence of comigrating bands in western blots of somatic tissue extracts, although antibodies in postpubertal sera recognized certain other proteins in somatic tissues. Several protein autoantigens, defined by sera from postpubertal animals, matched dominant autoantigens recognized by antibodies produced in response to vasectomy, prepubertal vas obstruction, or immunization with spermatozoa. This finding indicates that the antisperm antibody responses following sperm immunization, vasectomy or prepubertal vasal obstruction represent accentuation of an autoantibody response to sperm that develops normally following puberty.

Antisperm autoantibody responses to vasectomy and vasovasostomy in Fischer and Lewis rats.

Antisperm autoantibodies were studied in Fischer and Lewis strains of rats after either vasectomy, vasectomy followed one month later by vasovasostomy, or sham operations. The time course of antibody response to sperm protein autoantigens was assayed by Western blot analysis of sera obtained at intervals up to 3 months. Rats of both strains responded to immunization with isologous spermatozoa with production of high titer hyperimmune sera. Sera from vasectomized Fischer rats showed antisperm antibodies on Western blots, but bands were stained with less intensity and frequency than for Lewis rats. In both Fischer and Lewis strains, major protein autoantigens were observed at 75-83, 68-71, 63, 57, 51, 41, and 21-23 kDa, lending support to the hypothesis that there is a set of dominant sperm autoantigens recognized by a consensus of postvasectomy rat sera. The lesser response of Fischer rats to vasectomy was not due to absence of dominant postvasectomy sperm autoantigens in Fischer sperm extracts, nor was it attributable to inability of Fischer rats to mount an immune response to these antigens, since immunization with isologous sperm was successful in raising antibodies to the dominant autoantigens. Vasovasostomy did not result in a general decrease in antisperm antibodies, and reactions to some antigens actually increased.

Temporal recognition of sperm autoantigens by IgM and IgG autoantibodies after vasectomy and vasovasostomy.

Temporal patterns of IgM and IgG autoantibodies to sperm proteins were studied by western blot analysis at intervals after bilateral vasectomy, vasectomy followed one month later by vasovasostomy, or sham operations. Responses were detected to eight major autoantigens at 21-23, 36, 41, 51, 57, 63, 68-71 and 75-83 kDa, by study of staining patterns of sequential serum samples from individual animals and by analysis of the incidence of reaction to each protein. The four lower molecular weight antigens (21-23, 36, 41 and 51 kDa) provoked mainly IgG responses. The strongly stained set of higher molecular weight antigens (57, 63, 68-71 and 75-83 kDa) tended to show more clearly defined temporal patterns of IgM followed by IgG response, including a high incidence of IgM antibody at the 2-week interval. Three of the larger peptides (57, 63 and 68-71 kDa) appeared highly immunogenic, since some reactions were detected even in sham-operated rats. The classical patterns of IgM and IgG antibody responses to the majority of the dominant sperm autoantigens are in accord with the hypothesis that vasectomy mimics immunization with spermatozoa. The high incidence of IgM antibodies in the earliest sample, taken 2 weeks after vasectomy, suggests that the initial immunizing event takes place within about a week after the operation. Vasovasostomy did not bring about a decrease in antisperm antibodies. Instead, some animals demonstrated an increased reaction to certain antigens after reversal of vasectomy, even though the vasovasostomies were anatomically successful.

PIP: The production of antisperm antibodies is common subsequent to vasectomy and antisperm antibodies frequently persist following the reversal of vasectomy. The number of such antibodies may even increase after vasovasostomy. Using adult male Lewis rats, the authors analyzed the dominant autoantigens which evoke IgM and/or IgG autoantibodies after vasectomy by western blotting (WB) methods, the temporal patterns of IgM and IgG autoantibodies to specific sperm proteins, and the influence of vasovasostomy upon IgM and IgG antisperm autoantibodies. The temporal patterns were studied by WB at intervals after bilateral vasectomy, vasectomy followed 1 month later by vasovasostomy, and fake operations. Responses were detected to 8 major autoantigens of 21-23, 36, 41, 51, 57, 63, 68-71, and 75-83 kDa through the study of staining patterns of sequential serum samples from individual animals and by analysis of the incidence of reaction to each protein. The 4 lower-molecular-weight antigens provoked mainly IgG responses, while the strongly stained higher-molecular-weight antigens showed more clearly defined temporal patterns of IgM followed by IgG response, including a high incidence of IgM antibody at the 2-week interval. The peptides of 57, 63, and 68-71 kDa seemed to be highly immunogenic, since some reactions were detected even in rats which received only a fake operation. Results support the hypothesis that vasectomy mimics immunization with spermatozoa, while the high incidence of IgM antibodies in the earliest sample, taken 2 weeks after vasectomy, suggests that the initial immunizing event occurs within approximately 1 week after the operation. Vasovasostomy caused no decrease in antisperm antibodies.

Immunological response in the primate oviduct to a defined recombinant sperm immunogen.

Assessment of immune responses in the oviduct is of importance in understanding reproductive tract responses to infections, vaccination against reproductive tract pathogens, or contraceptive immunogens. This review discusses a technique that permits repeated sampling of oviductal fluid from the same monkey at intervals spanning up to several years, and the analysis of antigen-specific immunoglobulins in the fluid. This technique is important to immunocontraceptive development because previous studies in primates have lacked information on oviductal immune responses and contraceptive efficacy may not correlate well with serum antibody titers. Thus, a reliable method of sampling oviductal fluid before and after immunization with a defined antigen is required to determine the quantity and type of local immune responses necessary to achieve contraceptive effects. Implantation of access ports proved useful for repeatedly aspirating oviductal fluid in vivo from cynomolgus monkeys that was free from artifactual contaminants and with no observable changes in the behavior or health of the animals. Subsequent assays of relative and absolute concentrations of antibodies in oviductal fluid and serum demonstrated the presence of IgA and IgG specific for the recombinant sperm immunogen SP-10 in fluid collected from the periovulatory oviduct of primates after intramuscular inoculations. The antibodies evoked by the recombinant sperm vaccinogen recognized the endogenous antigen target on both human and macaque sperm, lending support for the possibility of developing a contraceptive immunogen that prevents fertilization.

Post-obstruction rat sperm autoantigens identified by two-dimensional gel electrophoresis and western blotting.

Although antisperm autoantibody responses to obstruction of the male reproductive system have been documented, information on the nature of the cognate sperm autoantigens has been limited. In the present study, the patterns of sperm autoantigens recognized by sera from rats after obstruction of the vas deferens or epididymis were studied by high resolution two-dimensional (2-D) gel electrophoresis and western blotting. Comparisons of patterns of autoantigens stained on 2-D western blots of sera from prepubertal vasectomy, prepubertal epididymal ligation and adult vasectomy groups revealed both similarities and differences. Sera from sham-operated animals showed no detectable reaction or much lighter staining of a small number of spots. Visualization of sperm autoantigens on 2-D western blots supported the hypothesis that there is a relatively small set of sperm proteins that can be regarded as dominant post-obstruction sperm autoantigens because they are recognized by multiple post-obstruction sera. The 2-D analysis revealed previously undetected distinctions in the autoantigens recognized after adult and prepubertal vasectomy, as well as variations with the site of obstruction. These differences in the response may be due in part to changes in antigens of spermatozoa in different parts of the tract and at different ages, as well as variations in exposure of sperm cell proteins to the immune system resulting from the sites of spermatic granulomas. Preparative 2-D gels and western blotting with post-obstruction sera are now being used to identify specific sperm autoantigens by microsequencing of selected proteins.

Effects of vasectomy on the epididymis.

Common principles can be discerned in the response of the epididymis to vasectomy, despite species differences. Increases in the size and number of lysosomes are the most frequent changes in the epididymal epithelium. The presence or absence of additional alterations such as changes in the height of the epithelium may be related to variations in distensibility of the vas deferens and epididymis. Direct measurements by micropuncture of epididymal and seminiferous tubule hydrostatic pressure indicate that, contrary to dogma, increased pressure in the distal epididymis after vasectomy is not generally transmitted to the seminiferous tubules. The epididymal interstitium shows microscopic changes indicative of chronic inflammation, with infiltration of macrophages, lymphocytes, and plasma cells, and rats with these lesions have higher antisperm antibody levels than animals lacking epididymal changes. Macrophages and neutrophils may enter the duct through the epididymal epithelium, at sites of rupture of the duct, and in the efferent ductules. Cyst-like spermatic granulomas occur in virtually all species where the epididymis or vas deferens ruptures with escape of spermatozoa. The sites and timing of granuloma formation may depend on the mechanical properties of the tract in different species, and they are probably important in the immune response to vasectomy. Postvasectomy sera in Lewis rats recognize a consensus repertoire of dominant autoantigens that closely resembles the antigens bound by sera from rats immunized with isologous spermatozoa. There are multiple routes for disposal of the sperm that continue to be produced after vasectomy.

PIP: The changes in the epididymal epithelium, luminal contents, inflammation in the epididymal interstitial tissue, and gross epididymal alterations after vasectomy are described. Studies of vasectomy and its reversal by vasovasostomy in the rat as a model system conducted over the decade prior to 1993 were reviewed. Common principles can be discerned in the response of the epididymis to vasectomy, despite species differences (rat, rabbit, guinea pig, and hamster). Increases in the size and number of lysosomes are the most frequent changes in the epididymal epithelium. The presence or absence of additional alterations such as changes in the height of the epithelium may be related to variations in distensibility of the vas deferens and epididymis. In the guinea pig and hamster the intratubular hydrostatic pressure in the seminiferous tubule was significantly lower (p 0.001) than in the caput epididymis. Direct measurements by micropuncture of epididymal and seminiferous tubule hydrostatic pressure indicate that, contrary to dogma, increased pressure in the distal epididymis after vasectomy is not generally transmitted to the seminiferous tubules. The epididymal interstitium shows microscopic changes indicative of chronic inflammation, with infiltration of macrophages, lymphocytes, and plasma cells, and rats with these lesions have higher antisperm antibody levels than animals lacking epididymal changes. Cyst-like spermatic granulomas occur in virtually all species where the epididymis or vas deferens ruptures with escape of spermatozoa. The sites and timing of granuloma formation may depend on the mechanical properties of the tract in different species, and they are probably important in the immune response to vasectomy. Postvasectomy sera in Lewis rats recognize a consensus repertoire of dominant autoantigens that closely resembles the antigens bound by sera from rats immunized with isologous spermatozoa. There are multiple routes for disposal of the sperm that continue to be produced after vasectomy.

Duration of the seminiferous epithelial cycle in the mature guinea pig: influence of unilateral orchiectomy.

The effect of unilateral orchiectomy on the seminiferous epithelial cycle in the mature guinea pig was studied. No significant change in the cycle duration was found. Thus, the previously reported hyperplasia of the contralateral testis is due to an increased number of cells entering the maturation process rather than to an acceleration of the cycle of seminiferous epithelium.

Antisperm autoantibody response is reduced by early repair of a severed vas deferens in the juvenile rat.

OBJECTIVE: To determine whether antisperm autoantibody production after prepubertal vas injury is influenced by immediate repair of the vas compared to delay of the reanastomosis until sexual maturity. DESIGN: Animal study comparing early repair, late repair, and sham-operated groups. SETTING: Research laboratory in a medical school. PATIENT(S): Lewis rats. INTERVENTION(S): After division of the vas deferens in juvenile rats, animals in an early repair group had the vasa repaired immediately by using an absorbable intraluminal stent. Animals in a late repair group had vasa obstructed by ligation until after puberty, when they underwent microsurgical vasovasostomy (age 60 days). MAIN OUTCOME MEASURE(S): Antisperm antibodies were assayed by ELISA. The weights of reproductive organs were determined, and samples of testis were studied by light microscopy. RESULT(S): The antisperm antibody response was less when the vas was repaired immediately than if the repair was delayed until after puberty. There was a low incidence of testicular alteration in the repair groups and none in sham-operated animals. CONCLUSION(S): If the vas deferens is injured or obstructed prepubertally, there may be a benefit to considering immediate repair to reduce the likelihood of developing antisperm autoantibodies, which have been associated with reduced fertility.

Factors that influence fertility after vasovasostomy in rats.

OBJECTIVE: To determine if fertility after vasovasostomy of immunologically responsive Lewis rats differs from that of the less responsive Sprague-Dawley strain and to relate fertility to antisperm antibodies, fluid flow in the vas deferens, and testicular structure. DESIGN: Male rats received: (1) bilateral vasectomies; (2) vasectomies followed 3 months later by vasovasostomy; or (3) sham operations. SETTING: Research laboratory. MAIN OUTCOME MEASURES: Fertility was assessed by caging males with three females for 2 weeks and subsequently counting implantation sites. Antisperm antibodies were measured with an enzyme-linked immunosorbent assay, fluid flow through vas deferens segments was tested in vitro, and testicular structure was studied microscopically. RESULTS: Nearly all vasovasostomized Lewis rats were infertile (33 of 34), whereas 62% (18 of 29) Sprague-Dawley rats were fertile after vasovasostomy (P less than 0.001). In fertile Sprague-Dawley males, significant correlations existed between: (1) implantation sites or females impregnated; and (2) antisperm antibodies early after vasectomy, vas flow, and testicular morphology. CONCLUSIONS: Genetic differences affect fertility after vasovasostomy. Fertility after vasovasostomy is also influenced in a multifactorial manner by the immune response, mechanical elements, and structural changes in the reproductive tract.