STUDIES ON THE CAUSE OF SPERMATOGENIC FAILURE IN SEMINAL TRACT OBSTRUCTION

采用间接免疫珠试验检测52例输精管梗阻患者血清中的抗精子抗体，其中输精管切除术12例，疝修补后梗阻21例，附睾梗阻12例，输精管闭锁7例。分别有46%和15%的血清igg抗体和igg A抗体呈阳性。抗体阳性的发生率与梗阻的原因没有明显的相关性。血清抗精子抗体对患者生殖力无影响。对32例精道梗阻患者进行了睾丸组织学定量分析。阻塞的原因和时间对精原细胞、精母细胞和精母细胞的支持细胞比例没有影响。然而，输精管切除术后患者的管壁厚度明显比疝修补术后患者厚。血清抗精子抗体不影响睾丸精子的发生。用流式细胞术观察输精管切除术对成年豚鼠精子发生的影响。在单侧输精管结扎6个月后，输精管结扎组和对照组的睾丸精子发生均恶化。对侧睾丸DNA直方图正常。如果存在抗精子抗体，则不影响精子发生，手术后睾丸的生精失败可能是由输精管切除术以外的因素引起的。总之，本研究表明血清抗精子抗体对睾丸精子发生无影响。梗阻引起的精道压力增加对精子发生的影响还有待研究。

Antisperm antibodies were tested using an indirect immunobead test in the sera of 52 patients with seminal tract obstruction : 12 with vasectomy, 21 with post-herniorrhaphy obstruction, 12 with epididymal obstruction and 7 with vas deferens atresia. Forty-six percent and 15% of the sera were positive for Ig G and Ig A antibodies, respectively. There was no siginificant correlation between the incidence of positive antibodies and the cause of the obstruction. Serum antisperm antibodies had no effect on patient fertility after seminal tract reanastomosis.Quantitative analysis of testicular histology was performed in 32 patients with seminal tract obstruction. The cause or the period of the obstruction had no effect on the Sertoli cell rations for spermatogonias, spermatocytes or spermatids. However, the tubular wall thickness was significantly thicker in the post-vasectomy patients than in the post-herniorrhaphy patients. Serum antisperm antibodies do not affect testicular spermatogenesis.The effect of vasectomy on spermatogenesis was investigated using adult guinea pigs by flow cytometry. Six months after unilateral vasectomy, the spermatogenesis of the operated testis deteriorated in both the vasectomy and control groups. The contralateral testis showed normal DNA histograms. Antisperm antibodies, if present, do not affect spermatogenesis and that the spermatogenic failure of the operated testis may be caused by factors other than vasectomy.In conclusion, the present study indicated that serum antisperm antibodies had no effect on testicular spermatogenesis. The effect on spermatogenesis of an increase in the seminal tract pressure caused by obstruction remains to be studied.