“Post vasectomy antisperm immune reaction after testosterone-induced azoospermia”.

We describe preliminary experiments on the effects of testosterone-induced azoospermia on post-vasectomy antisperm antibody reaction in two subjects. Progressive resumption of spermatogenesis following gradual suspension of testosterone therapy was still associated with antisperm antibody formation. Post-vasectomy antisperm antibody production does not seem to be triggered exclusively by acute, sudden and massive reabsorption of spermatoza after vasectomy but also by slow, gradual and late sperm antigen reabsorption. PIP: To learn more about the post-vasectomy autoimmune antisperm reaction, vasectomy was performed on 2 subjects who had achieved azoospermia through the administration of 250 mg/week of testosterone enanthate. Once the subjects had been azoospermic for 3 weeks and the vasectomy had been performed, testosterone administration was gradually reduced to allow spermatogenesis to resume. The tray agglutination test was used to detect sperm agglutinating antibodies. Antisperm antibody reaction was recorded in both subjects 3 months after vasectomy. The agglutination was head-to-head or mixed, not tail-to-tail. The antisperm antibody reaction was found only in blood in the 1st subject and in serum and seminal plasma in the 2nd subject. These findings appear to refute the authors' original hypothesis that it is the massive, sudden contact between antigens present on the spermatozoa and the immunocompetent cells that produces the post-vasectomy autoimmune reaction. Rather, it appears that the gradual and late reabsorption of sperm antigens resulting from the resumption of spermatogenesis after testosterone cessation acts as an antigenic stimulus in vasectomy patients. At present, the authors are investigating whether the immunological response is altered through the testosterone-induced block of spermatogenesis when testosterone treatment is continued for a longer period after vasectomy.