Search

The clinical workup of the infertile male with azoospermia aims at determining the aetiology and estimating the chances of finding spermatozoa by testicular sperm extraction (TESE). To establish prognostic criteria, 1583 consecutive patients with azoospermia consulting the Centre of Reproductive Medicine and Andrology, Munster, a tertiary referral centre, between 1976 and 2009 comprising 9.8% of all patients providing a semen sample were included in this retrospective analysis. The frequencies of diagnoses were as follows: 21% genetic causes (14% Klinefelter syndrome, 1% other chromosomal aberrations, 2% Y-chromosomal microdeletions, 1% hypogonadotropic hypogonadism, 3% congenital bilateral absence of the vas deferens), 31% current or former maldescended testes, varicocele, urogenital infections, 15% malignancies, 11% obstructions, 7% endocrine or other chronic diseases and 12% idiopathic azoospermia. Receiver-operating characteristic curves for chances of finding spermatozoa by testicular biopsy were calculated for testicular volume, serum follicle-stimulating hormone (FSH) and the seminal markers α-glucosidase, fructose and zinc where these data were available (N=283). Histograms of the seminal markers comparing data from men with obstructive azoospermia and normozoospermia visualize their discriminating power. Evidence-based threshold values for high chances of positive testicular biopsy serving as surrogate marker for TESE were derived from the subgroup of men with obstructive azoospermia for testicular volume (≥21mL), FSH (≤10U/L) and seminal α-glucosidase (≤18mU/ejaculate). Fructose and zinc could not predict the chances of finding spermatozoa upon biopsy. Based on these three parameters, positive biopsy and presumably TESE success can be quickly and reliably estimated in everyday practice with the colour-coded figures constructed from these data. As a seminal α-glucosidase reference limit of 18mU/ejaculate can also be used to diagnose congenital bilateral absence of the vas deferens, α-glucosidase (rather than seminal fructose) should be determined as part of the clinical routine when counselling patients before testicular biopsy.

Despite several efforts to standardize methods of semen analysis, sperm count is known to be subject to large interlaboratory differences. This is especially a problem in multicentre clinical trial settings and protocols for the preparation of semen for centralized assessment of sperm concentration are suggested here. The stability of semen has been tested after fixation with formalin at different dilutions and at different temperatures for different sperm concentrations. Sperm concentrations in formalin-fixed semen (at dilutions 1 + 0.5 to 1 + 19) were stable (

The Sperm-Class Analyser was validated for assessing morphometric parameters of the head and midpiece of unwashed and washed human ejaculated spermatozoa from volunteers providing a wide range of semen quality. A higher proportion of sperm could be assessed (86% fresh semen and 75% washed sperm) if Hemacolor staining was used rather than DiffQuik (80 and 73%) or Papanicolaou (78 and 68%). Different stains employed different fixatives and the area, length, width and perimeter of the sperm head was significantly larger for washed sperm stained by Hemacolor and DiffQuik. Acrosomal area ranged from 48 to 51% of the sperm head area and this percentage was larger for washed sperm stained with DiffQuik. Sperm at the end of the slide, distant from the initial semen droplet, were larger in area and perimeter than those at that site or in the middle. The high precision and reproducibility of the equipment required assessing only 50 sperm on the slide. Far greater variation was found in head width, relative acrosomal area and midpiece width between different slides prepared from the same ejaculate, highlighting the inherent variability within the ejaculate and smear preparation, and requiring more than one slide to be assessed.

The antifertility action of (R,S)-alpha-chlorohydrin administered orally to male rats was compared with that of several novel chlorinated compounds known to inhibit glycolysis and the kinematics of rat sperm in vitro. Oral gavage of 1,6-dichloro-1,6-dideoxy-D-fructofuranose (dichlorodideoxyfructose, DCF), 1-chloro-3-hydroxypropanone, its dimethylketal and bromopyruvate did not reduce the fertility of male rats below that of controls at the equivalent antifertility dose of (R,S)-alpha-chlorohydrin (5 mg/kg/day) or higher. As anticipated for a compound cleaved to products of (S)-chirality even high doses of DCF (200 mg/kg) showed no effect on renal function. 36Cl-Labelled DCF administered orally to male rats was eliminated only slowly in the urine (16% of the ingested dose excreted in 96 h). In the first 8 h, approximately 50% of DCF was excreted unchanged, 30% was excreted as 3-chlorolactate (BCLA), the oxidation product 3-chlorolactaldehyde and 25% as Cl-. By 24 h little DCF remained and the major metabolite (70%) was BCLA and 20% Cl-. The high rate of dechlorination is most likely responsible for the low antifertility action of DCF.

(R,S)-Ornidazole, an effective antifertility agent for male rats at 400 mg/kg/day, was ineffective at this dose in male mice and at 1000 mg/kg/day caused neural effects. The compound was not excreted unchanged and more polar metabolites and Cl- were detected in 0-8 h urine following a single injection (400 mg/kg). In 8-24 h urine even these metabolites and most Cl ion were absent, indicating rapid metabolism of ornidazole. There was no organ specific accumulation of 36Cl-(R,S)-ornidazole in murine tissues. After injection of 36Cl-(R,S)-alpha-chlorohydrin, another antifertility agent in the rat but not the mouse, there was also no tissue-specific accumulation of radioactivity in the reproductive tract of either species. Urinary excretion rates of alpha-chlorohydrin were twice as rapid in mice as in rats. In mice, alpha-chlorohydrin was the major urinary metabolite, but in the rat metabolites included Cl-, 3-chlorolactate (BCLA) at 5 and 10 h and BCLA only at 24 h. BCLA was the major metabolite detected in most tissues at 10 and 24 h. In the rat cauda (but not caput) epididymidis the glycolytic inhibitor 3-chlorolactaldehyde was present at 5 h (but not 10 h), indicative of early metabolism. These results demonstrate a greater metabolism and excretion of putative antifertility agents in the mouse than the rat, lowering the amount of effective inhibitor circulating in the animal, which may explain why (R,S)-alpha-chlorohydrin and (R,S)-ornidazole are ineffective in this species at the dosages and injection times used, despite their spermatozoa being sensitive to inhibition by (R,S)-alpha-chlorohydrin in vitro.

One semen analysis laboratory [the Institute of Reproductive Medicine (IRM), Munster, Germany] was enrolled in three external quality assurance programmes in Europe (United Kingdom External Quality Assurance Scheme, European Academy of Andrology, European Society of Human Reproduction) that control for the assessment of sperm concentration, sperm motility and sperm morphology. Agreement between the participating laboratory and the sperm concentrations designated by all three programmes was good. Disagreement between two quality control (QC) programmes providing motility assessment was particularly noticeable in the distinction between motility grades a and b. For the identification of normal sperm morphology, marked differences between the standards set by different QC programmes were apparent. One programme was stricter in its categorization of normal forms, such that an overestimation of normal forms was diagnosed at IRM, whereas agreement with the other programmes was achieved. Variation of results from technicians in the IRM internal QC programme was

Chlorinated antifertility compounds are known to inhibit glycolysis of spermatozoa as they reside in the epididymis but new compounds need to be evaluated that retain antifertility action but do not exhibit side-effects. In this study, two known antifertility agents and a related compound were compared for their inhibition of rat sperm metabolism and motility in vitro. The dose-dependent inhibition in vitro of the glycolytic enzymes glyceraldehyde-3-phosphate dehydrogenase (GAPDH) and triosephosphate isomerase (TPI) of distal cauda epididymal rat spermatozoa by (R)-, (S)- and (R,S)-ornidazole (ORN), (R,S)-alpha-chlorohydrin (ACH) and 1-chloro-3-hydroxypropanone (CHOP) was compared. The direct inhibition of GAPDH by ORN suggests that it inhibits without prior conversion outside the cell but inhibition was not stereo-specific. The GAPDH, but not TPI, activity of spermatozoa incubated with ACH and CHOP was highly correlated with kinematic parameters of spermatozoa incubated in pyruvate- and lactate-free medium. ACH only inhibited the activity of intact spermatozoa and the inhibition was not reversed by washing the particulate sperm fraction after sonication. High concentrations of ACH (100 mmol/L) killed intact rat spermatozoa and decreased the extent of GAPDH inhibition. CHOP, unlike ACH, was an effective inhibitor of both intact and sonicated cells. Pre-CHOP, the dimethylketal precursor of CHOP, and its other hydrolysis product MeOH, were both ineffective in vitro. CHOP and related ketals may be more effective inhibitors of sperm glycolysis than ACH and may prove useful for investigating sperm-specific glycolytic inhibition, a prerequisite for the development of antiglycolytic, post-testicular acting contraceptives.

Some 30 years ago, alpha-chlorohydrin and some analogues were considered as close to the ideal contraceptive which acted rapidly and reversibly on the post-testicular maturation of spermatozoa. Despite their early promise, research funding was withdrawn only 5 years later because of what were considered to be unacceptable side-effects in primates. The literature on the toxic effects of these contraceptive agents was reviewed and was found to be wanting in respect to the rigour of scientific methods applied (impure compounds were used, inappropriate target populations were studied, excessive doses were employed, abstracts were cited from which no full publications subsequently arose). These compounds remain the closest approach yet to non-hormonal contraceptives for males and have led to the synthesis of related compounds which have a similar antifertility action but with much diminished toxicity. If toxicity remains a problem, a range of other compounds now known to have a similar antifertility action, should be investigated.

This work demonstrates similarities between epididymal basal cells and macrophages in the mouse. Light microscopic studies of the postnatal development of the murine epididymis showed that basal cells were not present before days 12, 14 and 16 in the cauda, caput and corpus epididymis, respectively. An increase in cell number per unit length of tubule perimeter was demonstrated in all segments between days 20 and 27, when testicular fluid and spermatozoa start entering the epididymis. In the adult, there were more basal cells per unit perimeter in the cauda than caput or corpus epididymis. Conspicuous and consistent expression by basal cells of antigens detected by antibodies against tissue-fixed macrophages (F4/80) and mature macrophages (Mac-1) occurred only after they became established within the epithelium. Basal cells in the cauda epididymis did not display either antigen in the adult, although they persisted in the caput region. Such developmental patterns are compatible with the hypothesis that basal cells play a role in immune defence against sperm autoantigens.

The osmolality of 18 liquefying human semen samples from 15 volunteers was measured by vapour pressure osmometry to be low (294 mmol/kg, range 269-311). For each sample the osmolality increased during liquefaction to reach a mean of 312 mmol/kg (280-331) by 30 min at 37 degrees C. These results are at variance with the widely held view that semen osmolality is greater than that of serum, which results from its first being examined after liquefaction in vitro. Thus when sperm are routinely examined after liquefaction they have been subjected to osmotic stresses that are not experienced by spermatozoa entering the female tract at coitus.

Bradykinin (BK) has been suggested to be an active substance in the disputed therapeutic use of kallikrein to improve semen quality. The effects of exogenous BK and its antagonist Hoe 140, which acts on one of the bradykinin receptors (BK2), were examined in two groups of patients attending the fertility clinic: those with asthenozoospermia (group I) and normozoospermia (group II). Bradykinin (10nM-1 microM) added to washed human spermatozoa had no effect on most kinematic parameters and caused only a marginal increase (7%) in curvilinear velocity at 50 nM in group I patients; however, this increase was not suppressed by concomitant addition of the BK antagonist. The bradykinin antagonist itself had no effect on the percentage motility or kinematic motility parameters of washed human spermatozoa in either group of patients. The motility of spermatozoa in semen was also unaffected by the presence of the bradykinin antagonist. It is concluded that bradykinin does not act exogenously on washed spermatozoa nor endogenously on spermatozoa in semen to stimulate motility via BK2 receptors, regardless of the initial quality of the sperm motility.

Summary Selecting a population of spermatozoa by the swim-up technique yields, after freezing and thawing, a population of cells that contains proportionally more spermatozoa which are morphologically normal, fewer spermatozoa with damaged tail membranes, and a greater percentage of progressively motile spermatozoa with greater velocities and amplitudes of head displacement than those obtained after freezing and thawing the same semen samples in the normal way. This pattern was found for the semen from 10 patients and five volunteers. However, the cells selected by swim-up were as susceptible to the stresses caused by freezing and thawing as unselected spermatozoa in the original semen sample, and the improvement came from the better quality of the initial sample.

Despite the high water-permeability of human spermatozoa, little is known about the identity and the role of aquaporins (AQP) in them or germ cells. Using ejaculates from donors, sperm AQPs were identified by western blotting followed by the analysis of mRNA with RT-PCR. Protein expression in the testis and spermatozoa was localized by immunocytochemistry. Inhibitors were used to investigate the involvement of aquaporins in water transport when ejaculated spermatozoa were swollen in medium mimicking uterine hypo-osmolality by quinine that blocks volume regulation. Sperm AQP7 and AQP8 in 39 infertile patients and 11 healthy donors were quantified by flow cytometry. AQP1 was absent from spermatozoa. Sperm and testicular AQP7-9 had nucleotide sequences identical to those of somatic cells but AQP8 mRNA also showed shorter variants. AQP7 was expressed abundantly by round and elongated spermatids and ejaculated spermatozoa, AQP8 by all germ cells and spermatozoa, and AQP9 rarely by spermatocytes or Sertoli cells. Protein bands showed specificity by western blotting for AQP7 and AQP8 but not AQP9. The absence of sperm AQP9 was further suggested by the ineffectiveness of its inhibitor phloretin in blocking quinine-induced swelling, but HgCl(2,) which inhibits AQP8, was effective. Sperm AQP7 expression was correlated with progressive motility and was lower in patients than in donors. Sperm AQP8 expression was inversely correlated with the extent of sperm coiling, which is a swelling phenomenon, but showed no difference between patients and donors. In conclusion, AQP7 and AQP8 were identified in human spermatozoa and could play a role in glycerol metabolism and water transport respectively.

Biochemical analysis was made of specific accessory gland products in the ejaculates of 362 men suffering from various acute inflammatory diseases of the reproductive tract and 33 normozoospermic patients acting as controls. The ejaculate content of the epididymal markers alpha-glucosidase and L-carnitine, but not glycerophosphocholine, was significantly reduced in ejaculates from men with epididymitis; citric acid was reduced in men suffering from prostatitis; both citric acid and alpha-glucosidase were reduced in men suffering from adnexitis. The ejaculate content of epididymal and prostatic markers in prostato-urethritis (adnexitis), where the exact localization of the inflammation was unclear, was not as low as in epididymitis or prostatitis. Seminal vesicle function, as judged from semen volumes and seminal fructose, was not different in these groups of patients. The results, although strongly related to the clinical diagnosis, were unrelated to the microbiological flora of the semen and indicate that both the epididymis and the prostate glands are involved in some forms of adnexitis.

The Sperm-Class Analyser was validated for assessing morphometric parameters of the head and midpiece of unwashed and washed human ejaculated spermatozoa from volunteers providing a wide range of semen quality. A higher proportion of sperm could be assessed (86% fresh semen and 75% washed sperm) if Hemacolor staining was used rather than DiffQuik (80 and 73%) or Papanicolaou (78 and 68%). Different stains employed different fixatives and the area, length, width and perimeter of the sperm head was significantly larger for washed sperm stained by Hemacolor and DiffQuik. Acrosomal area ranged from 48 to 51% of the sperm head area and this percentage was larger for washed sperm stained with DiffQuik. Sperm at the end of the slide, distant from the initial semen droplet, were larger in area and perimeter than those at that site or in the middle. The high precision and reproducibility of the equipment required assessing only 50 sperm on the slide. Far greater variation was found in head width, relative acrosomal area and midpiece width between different slides prepared from the same ejaculate, highlighting the inherent variability within the ejaculate and smear preparation, and requiring more than one slide to be assessed.

3-(36)Chloro-1-hydroxypropanone (CHOP), a specific inhibitor of sperm glycolysis in vitro, is rapidly metabolized by the male rat to alpha-chlorohydrin, 3-chlorolactate and the inhibitory sperm metabolite, 3-chlorolactaldehyde, presumably all being of the (S)-configuration. The dimethyl ketal of (36)Cl-CHOP [3-(36)Cl-dimethyl-CHOP] is rapidly metabolized producing identical metabolites and excreted radioactivity in urine at a similar rate. As neither compound produced diuresis, glucosuria or induced the formation of spermatocoeles, conditions associated with related male antifertility and antiglycolytic agents, they could represent an alternative means of producing (S)-3-chlorolactaldehyde within spermatozoa in vivo.

Unilateral ligation of the mid-corpus epididymis, the proximal vas deferens and imposition of an abdominal temperature for 6 days as well as bilateral castration for 3, 6 or 14 days, resulted in a change in epithelial composition of the adult murine epididymis with regard to the number and antigen expression of basal cells. There were fewer basal cells per tubule cross-section with fewer expressing F4/80 antigen when spermatozoa were absent from the proximal lumen following short-term castration. Conversely, more basal cells with more of them demonstrating macrophage antigen expression were evident when more or damaged spermatozoa were in the proximal lumen after corpus ligation and exposure to abdominal temperature or in the cauda after long-term withdrawal of androgen support. By contrast, ligation of the vas deferens did not lead to tubule distension, and hence sperm accumulation, and did not alter the basal cell population in the cauda epididymis. The data suggest that epididymal basal cells respond in number and macrophage antigen expression to the presence of sperm autoantigens in the lumen with little dependence on circulating androgens. These changes may represent responses to minimise the interaction of sperm autoantigens with the immune system and the risk of immunological infertility.

This work demonstrates similarities between epididymal basal cells and macrophages in the mouse. Light microscopic studies of the postnatal development of the murine epididymis showed that basal cells were not present before days 12, 14 and 16 in the cauda, caput and corpus epididymis, respectively. An increase in cell number per unit length of tubule perimeter was demonstrated in all segments between days 20 and 27, when testicular fluid and spermatozoa start entering the epididymis. In the adult, there were more basal cells per unit perimeter in the cauda than caput or corpus epididymis. Conspicuous and consistent expression by basal cells of antigens detected by antibodies against tissue-fixed macrophages (F4/80) and mature macrophages (Mac-1) occurred only after they became established within the epithelium. Basal cells in the cauda epididymis did not display either antigen in the adult, although they persisted in the caput region. Such developmental patterns are compatible with the hypothesis that basal cells play a role in immune defence against sperm autoantigens.

Automated sperm morphology analysis (ASMA) technology has improved the assessment of sperm morphology, but the results depend on the use of adequate and standardized procedures. In this study the Sperm-Class Analyzer (SCA) ASMA system was used to assess sperm head morphometry in the Cynomolgus monkey and to evaluate the influence of sample size, intraslide variation, and the use of three staining techniques on the accuracy of image processing and sperm head morphometry. Haematoxylin is the staining technique of choice for Cynomolgus spermatozoa, as optimum contrast of sperm heads with the surrounding background allows efficient segmentation, i.e. sperm head boundary detection, making the image analysis process more accurate. The analysis of 100 spermatozoa is recommended since a larger sample size did not result in more accurate sperm head morphometry. There were no differences in either the percentage of correctly binarized sperm heads or sperm head dimensions among samples obtained from different zones of the slides, although differences in stain intensity (grey level) were detected. The measurements made on Haematoxylin, Diff-Quik and Hemacolor-stained slides yielded different values for all of the sperm head parameters under consideration. This result demonstrates that the procedures of fixation and staining significantly affect the dimensions of sperm heads.

Ornidazole, a 5-nitro-imidazole derivative, has contraceptive properties in rats. As some ornidazole passes through the body unmetabolized after administration, the aim of this study was to investigate if ornidazole itself has a direct effect on sperm motility and whether these effects are limited or potentiated by the epididymal epithelium or structural changes to the molecule. Cauda epididymal spermatozoa or cauda epididymal tubules were incubated with ornidazole or ornidazole analogues, and motility parameters were subsequently measured by means of a computer-assisted sperm analysis (CASA) system. Incubation of spermatozoa in 2.5 mmol/L ornidazole for 4 h reduced their motility significantly, whereas incubation of epididymal tubules for 8 h in 10 mmol/L ornidazole was required to alter the velocity parameters of the enclosed spermatozoa upon release, suggesting that extratubular non-metabolized ornidazole can participate in inhibiting the motility in vivo. The in vitro toxicity of ornidazole derivatives depends on the halogen present and on the position of the nitro-group. The putatively inactive (R)- and the active (S)-ornidazole exhibited equivalent depression of sperm motility by direct incubation. This observation, and the differences between the in vitro and the in vivo efficacies of various ornidazole analogues, indicates distinct mechanisms of motility inhibition in the two experimental systems.

The acquisition by spermatozoa of the capacity for movement upon liberation from the epididymal duct into buffer is one of the obvious changes associated with sperm maturation and, hence, studies of sperm kinematics might provide good indices for sperm maturation. Profiles of development in the movement pattern of spermatozoa taken from six regions of the epididymis were established in marmoset and cynomolgus monkeys using computer-assisted sperm analysis. Motion of spermatozoa from initial regions was sluggish and irregular, then developed in the more distal region into erratic movement effected by an increase in the vigour of flagellation as reflected by curvilinear velocity. The tendency of immature spermatozoa to display circular motion was more common in the marmoset than in the cynomolgus monkey. In the marmoset the most drastic changes in percentage motility and kinematic parameters of spermatozoa occurred between the distal caput and the proximal corpus; maximal values for these parameters were found around the distal corpus epididymis. For the cynomolgus spermatozoa the sharpest gain in percentage motility was also achieved between the caput and proximal corpus epididymis, but with full kinematic development in the proximal cauda epididymis. These maturational changes were not synchronous among spermatozoa from the same site as they moved along the epididymis, as reflected in the heterogeneity of each sample in the kinematic properties of individual spermatozoa, especially those from the proximal corpus epididymis. The maturational profiles in the monkeys are comparable to the situation in the human, for which they may provide a useful model.

Summary The maturation of sperm motility in the epididymis of the mouse was assessed using a computer-assisted sperm analysis system. Spermatozoa were immotile in the most proximal regions of the epididymis but developed motility rapidly in the proximal caput epididymis; the percentage motility remained high thereafter. In the caput, flagellar beat was erratic with little progression, but in the proximal corpus region circular movement patterns were reflected in reduced linearity (LIN) and straightness (STR) of the sperm tracks, although velocities were little changed and wobble (WOB) increased. In the mid-corpus region, however, all velocities, LIN, STR and WOB, increased markedly. In more distal regions there was little change in these parameters. Distribution curves of the kinematic parameters of spermatozoa obtained from each region indicated that the most heterogeneous population was that from the mid-corpus epididymis; the most homogeneous was that from the mid-cauda region. Individual sperm tracks revealed slowly progressing spermatozoa in the distal caput, transforming to motion in small circles, interrupted by more linear progression. More distally, linear progression was interrupted by looping movements and a generally progressive path was observed thereafter, with less deviation from the average path as the spermatozoa matured. Spermatozoa displaying motion compatible with passing the uterotubal junction were first found in the proximal corpus epididymis, in agreement with earlier in-vivo fertilization studies on where fertilizing capacity is achieved with epididymal spermatozoa.

Using 158 unselected semen samples the present study has analysed how the results of sperm morphology assessment were influenced by different techniques for preparing the slides for microscopic assessment. All three techniques compared, the Papanicolaou stain (PAP), the Shorr stain (SHO) and the 'wet preparations' protocol (WET) are currently recommended by the World Health Organization for use in andrology laboratories. Mean percentages of morphologically normal spermatozoa were identical on PAP and SHO slides (31.1%), but were significantly lower in wet preparations (12.3%). Wide divergence of results obtained with the three different methods was also found with respect to the percentage of sperm with head, midpiece and tail defects and two 'indices of teratozoospermia'. For the majority of parameters assessed, linear regression analysis revealed a poor correlation between evaluations of PAP, SHO and WET slides (r values ranging from 0.01 to 0.87). We conclude that only one standard method should be recommended for the preparation of morphology slides in order to ensure inter-laboratory comparability of results and to enhance the value of sperm morphology analysis for predicting fertility.

Summary Tubules isolated from the initial segment, caput and corpus regions of the rat epididymis were incubated for 4 h in medium containing rat IgG or bovine-serum-albumin (10 mg ml-1) and processed for light microscopy immunocytochemistry using gold-labelled anti-rat IgG and silver staining or peroxidase/anti-peroxidase techniques. Distribution of IgG was confined to the peritubular matrix only, with no detectable uptake into the epithelium or lumen. In tubules incubated with rat IgG coupled to gold particles as tracer and fixed for electron microscopy, the IgG-gold complex failed to penetrate to the base of the epithelium. When IgG-peroxidase conjugates were used, sparse enzyme activity was localized in small basal and apical vesicles and multivesicular bodies of the principal cells. However, this uptake could not be inhibited by the presence of a 30-fold excess of non-labelled IgG, and the same distribution of enzyme activity was also observed when tubules were incubated with a similar activity of horseradish peroxidase alone. These findings indicate that there is no detectable receptor-mediated transport of IgG across the epididymal epithelium, although non-selective transfer could occur via fluid-phase endocytosis.

Seminal alpha-glucosidase has been used clinically as a marker of epididymal function. In this study enzyme inhibitors were used to increase the specificity of the human seminal alpha-glucosidase assay and improve its diagnostic value as an indicator of distal epididymal occlusion in cases of azoospermia. Sodium dodecylsulphate was added to the sample to eliminate the interfering acid isoenzyme secreted by the prostate gland, and castanospermine was used with semen pools to provide a semen blank for the assay by eliminating non-glucosidase-regulated degradation of the substrate. With both inhibitors included in the assay, glucosidase activity in semen samples from 17 fathers was measured to provide reference values for the clinic (lower threshold 18 mU per ejaculate). With the improved assay glucosidase was non-detectable in 8 out of 11 cases of proven and 5 out of 8 cases of suspected ductal obstruction; other azoospermic patients with distal occlusion had values below 11 mU per ejaculate.

Summary Male mice were vasectomized by ‘open-ended’ or ‘closed’ techniques. After 4 weeks the cell-mediated immune reactions were compared with those of sham-operated animals by immunohistochemical localization of leucocytes, using specific monoclonal antibodies. Macrophages and MHC class II antigen-positive cells were the major cell types to appear in all regions of the epididymis after both types of operation. There was recruitment of T-helper/inducer leucocytes but not of T-suppressor-cytotoxic cells. An increased presentation of macrophage-migration inhibiting factor antigen appeared in interstitial and peritubular locations. After ‘closed’ and ‘open-ended’ vasectomy granulomata developed in the epididymis. The sperm-containing lumen of these granulomata was invaded by macrophages, MHC class II-positive cells and T-helper/inducer lymphocytes. This mouse model thus reveals a significant epididymal inflammatory response of the epididymis to vasectomy.

Summary Ligated tubules from the corpus epididymidis of men and monkeys were incubated in medium containing horseradish peroxidase (HRP) as a marker for fluid-phase endocytosis. HRP was localized by light and electron microscopy after 0, 15, 30 and 60 min of incubation. Movement between the cells was prevented by tight junctions, but bypass of this barrier was apparently achieved by an intracellular vesicular mechanism leading to a time-dependent appearance of HRP in the lumen. Uptake of HRP into basal cells and capture by the lysosomal apparatus of principal cells were also observed. HRP-filled vesicles also appeared in the basal, mid and apical cytoplasm of epithelial cells in the caput 1 h after injection of the tracer into the epididymal circulation of the monkey, suggesting that this pathway also operates in vivo.

When solutions containing high concentrations of sodium ions (c. 140 mM) were perfused for up to 6 h through the lumen of the cauda epididymidis of the anaesthetised rat, distended spaces were consistently seen between the epithelial cells, water resorption was measurable, and clear cells lacked large clear apical vacuoles. Lowering the sodium ion concentration decreased water resorption, and distended intercellular channels were absent. Under these conditions clear cells had abnormally large or numerous pale staining vacuoles. When physiological concentrations of sodium (20 mM) and potassium (50 mM) ions were perfused, a more normal epithelium was present; intercellular channels were absent, and water was either resorbed or secreted at low rates. Clear cells appeared normal initially, but had abnormal appearance after longer periods of perfusion.

The proportion of sperm from the caput epididymidis of the rat that swelled in hypo-osmotic media was reduced in a dose-dependent manner by detergents, with relative effectiveness as follows: CTAB greater than Digitonin greater than Hyamine 10-X greater than SDS greater than Triton X-100 greater than Deoxycholate. Polymyxin was a poor lytic agent, possibly because anionic lipids are in the inner leaflet of the membrane. Less digitonin was needed to lyse mature sperm from the distal cauda epididymidis, suggesting that there is less cholesterol in their membranes.

The entry of total radioactivity into the perfused tubule of the cauda epididymidis was measured during intravenous infusion of labelled steroids into the anaesthetised rat. The effect of altering the composition of the perfusate on this entry and the nature of radiometabolites was also studied. No radioactivity entered the epididymal lumen during infusions of cholesterol, and in the absence of luminal proteins the entry of isotope was generally low (< 14% plasma levels) for all steroids except dehydroepiandrosterone. C21/22-steroids exhibited a delay of about 30 min before a slow rise in luminal activity reached between 3% and 14% plasma levels. For C19-steroids a low plateau level of radioactivity was reached (at 6%-9% plasma levels) with dihydrotestosterone and androstenedione, whereas luminal activity continued to rise with respect to blood during infusions of dehydroepiandrosterone. When protein was added to the perfusing solution the delay in entry of radioactivity was decreased and plateau levels established for C21/22-steroids (at 14%-38% plasma levels). The extents of entry of dihydrotesterone and androstenedione were raised (34%-47%) and radioactivity continued to rise in the lumen relative to blood, but at a faster rate during infusions of dehydroepiandrosterone and perfusion with protein. Testicular fluid protein had little effect on the entry of activity for any steroid. There was no correlation between the extent of entry of tracer with binding of the steroids to plasma or perfusates, or partition into lipids. Tentative identification of metabolites indicated an entry of both dihydrotestosterone and dehydroepiandrosterone during their respective infusions. Androstenedione and androstanediols were excluded whereas 5 alpha-reduced metabolites appeared during of androstenedione and dehydroepiandrosterone.

An in vitro luminal perfusion technique was used to monitor the transepithelial movement of [3H]L-carnitine into the cauda epididymal lumen of rats. Movement of the volume marker [14C]inulin into the lumen was limited while the transport of [3H]L-carnitine was saturable and was dependent on respiratory energy. The transport of L-carnitine (50 microM) was significantly inhibited by 500 microM D-carnitine, palmitoyl L-carnitine and deoxycarnitine but not by trimethylammonium iodide, trimethyl phosphate, acetyl-L-carnitine, choline, betaine, gamma-aminobutyric acid or DL-carnitinamide. The Kt (116 microM) and Vmax (0.1 nmol/30 min/cm) for the carriers were calculated from the present data and as the Kt is about twice the normal plasma concentration of carnitine, the rate of transport by the pump is presumed to be limited by the plasma concentration.