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Immunological consequences of vasectomy.

Shahani SK, et al. Arch Androl. 1981.

Abstract

In more than 50% of men, vasectomy leads to auto-immune pathology. The auto-immune response to sperms following vasectomy is triggered by the phagocytosis of sperm in the epididymis. In the humoral immune response, sperm agglutinating, sperm immobilizing, and antibodies to sperm nuclear protamines occur, as early as 3-4 days after vasectomy. The incidence reaches 60-70% within 1 year and remains almost the same even after 20 years. Presence and effects of circulating immune complexes following vasectomy are discussed with reference to reported increased incidence of atherosclerosis and auto-immune orchitis in experimental animals. There is no positive conclusion whether vasectomy leads to cell mediated immunity to spermatozoa.

PIP:

Vasectomy leads to auto-immune pathology in more than 50% of men. The immunological changes, if any, following vasectomy can be manifested in 2 ways: those that affect anatomy, either gross, microscopic, or submicroscopic, and adverse effect on the physiological mechanisms in the reproductive tract could be due to the presence of antibodies to sperm-specific antigens and may cross react with other tissues and secretions in the body. Gross anatomical changes include cystic swelling at the site of operation and development of spermatic granuloma. Included among the histological changes in experimental auto-immune orchitis or after vasectomy are: varying degree of vacuolization of the Sertoli cells; premature exfoliation of immature germ cells; coalescence of cellular units of the germ cell clones from multinucleate giant cells; distortion of spermatid nucleus and acrosome; and retention and degeneration of late spermatids within the epithelium. In some pathological conditions such as vas obstruction and vasectomy, due to phagocytosis of the spermatozoa the soluble antigens of the sperm leak into the circulation and produce autoantibodies. Sperm agglutinating antibodies in sera have been detected as soon as the 3rd or 4th day after vasectomy, but they appear in the sera more commonly between 6 weeks to 6 months. Circulating sperm immobilizing antibodies are found in 1%-3% of the nonvasectomized individuals. Within 6 months post operation, about 31% of men develop these antibodies. Swollen sperm head antibodies are found in less than 2% of nonvasectomized male populations and in 28%-33% of vasectomized males within a year following the operation. Presence and effects of circulating immune complexes following vasectomy are reviewed with reference to reported increased incidence of atherosclerosis and auto-immune orchitis in experimental animals. There is no positive conclusions as to whether vasectomy results in cell mediated immunity to spermatozoa.

PMID

7283529 [Indexed for MEDLINE]

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