Obstructive infertility: changes in the histology of different regions of the epididymis and morphology of spermatozoa

Abstract

In the present study, the effects of prolonged obstruction in different regions of the human epididymis on its histology and on the spermatozoa retained at the site of obstruction were assessed. Men who were confirmed of having obstruction of the epididymis underwent vasoepididymostomy (VEA) for surgical correction of the obstruction. At the time of surgery, fluid from the epididymal tubule above the site of obstruction was aspirated and examined for sperm profile. Epididymal tissue, collected at the site of obstruction, was processed for assessment of histological changes and also used to identify the site of obstruction. Prolonged obstruction of the epididymis has caused degeneration of the epididymal epithelium, gradual decrease in the diameter of the tubule and tubular lumen and increase in the intertubular connective tissue. Sperm aspirated from the caput epididymal fluid showed sluggish pattern of motility only in one out of the six subjects, whereas spermatozoa collected from the cauda epididymal fluid showed rapid linear progressive motility in one of three subjects. A major percentage of spermatozoa in the aspirated fluid showed various types of morphological abnormalities, irrespective of the site of obstruction. These results are discussed in relation to the role of the epididymis in investing spermatozoa with motility and fertilizing capacity.

Multiple factors affecting surgical outcomes and patency rates in use of single-armed two-suture microsurgical vasoepididymostomy: a single surgeon′s experience with 81 patients

“…Pal found that more motile sperm indicated better results. 13 In our study, the patency rate was significantly different if motile sperm was found (80.4% vs 25.0%). We also noticed more motile sperm in the epididymal fluid intraoperatively a better and higher VE patency rate could be predicted.…”

Expression patterns of sex steroid receptors in developing mesonephros of the male mouse: three-dimensional analysis

“…However, development and function of the male reproductive tract, especially the cranial portion consisting of the efferent ductules (ducts), need appropriate activation of both the androgen and estrogen receptor pathways. In man, efferent ducts form the bulk of what is called the head or proximal part of the epididymis (Sullivan et al 2019; Légaré and Sullivan 2020) and pathological changes are more commonly found in this region in larger mammals, including obstructive lesions, which contribute substantially to male infertility (Ball and Mitchinson 1984;McEntee 1990;Rajalakshmi et al 1990; Pal et al 2006). The high incidence of epididymal disjunctions associated with epididymal anomalies points to the importance of understanding the endocrine regulation for development of the male ductal systems (Logsdon et al 2022).…”

A Single Administration of Progesterone during the Neonatal Period Shows No Structural Changes in Male Reproductive Tracts in Mice

“…Furthermore, obstructive lesions in the epididymis, especially in the proximal region, including the efferent ducts are not rare [ 1 ]. Patients with obstruction in the proximal region exhibit lower sperm motility and vitality than those with obstruction in the caudal region [ 34 ]. Therefore, it is important to understand what causes malformation and malfunction of the proximal region, including the efferent ducts.…”