Consequences of vasectomy: an immunological and histological study related to subsequent fertility.

ABSTRACT

PIP: A total of 42 patients was studied in vitro for cell-mediated immunity to sperm using lymphocyte transformation technique. A prior study of 23 patients who had had vasectomy was continued at 4 to 6 monthly intervals to complete a 2nd year following the vasectomy. Another group of 19 patients who had had vasectomy 2 to 8 years before was similarly studied for evidence of cell-mediated immunity to sperm. 11 of these patients subsequently had vasovasostomy with testicular biopsy at time of reversal. Histologically, the testicular tissues of the 11 patients during vasovasostomy exhibited significant abnormalities; all had intertubular edema and reduced spermatogenesis. The histological abnormality was not related to the duration of the vasectomy. 63.6% (7) of the wives of the 11 patients who had vasovasostomy conceived 5 to 24 months (average, 11.3 months) following anastamosis. The rest had euspermia and oligozoospermia. The histological abnormality was not associated with subsequent fertility or conception time. The in vitro study concluded that cell-mediated immunity to sperm did not occur within 1 year of vasectomy in man. The current study suggests that cell-mediated immunity to sperm does not occur at all after vasectomy; evidence for conception within a short time of operation indicates that fertility is not affected by persisting immune response to sperm.