Abstract
INTRODUCTION AND OBJECTIVES: During epididymal transit, spermatozoa acquire new surface proteins. P34H being one of them, it is implicated in sperm-zona pellucida binding. Absence of this surface protein is associated with inability of sperm to interact with the oocyte. We have previously shown that P34H was present in all fertile men and approximately in 50 % of idiopathic infertile men. We also showed that P34H remains at the same level in different semen from a given individual. Vasovasostomy has a high surgical success rate but fertility is not recovered in a significant proportion of cases. Knowing that vasectomy can cause epididymal damages, we have quantified P34H in vasovasostomized men with regards to the time elapsed between vasectomy and surgical reversal. METHODS: We retrospectively analysed 589 charts of patients between 1997 and 2006 who underwent a modified 1-layer microsurgical vasovasostomy performed by a single surgeon. P34H evaluated by western blot analysis performed on a constant number of spermatozoa was available for 107 patients. Of these, 9 patients were excluded due to protein degradation on western blots. RESULTS: : P34H decrease in a steady fashion for the first 9 years of interval between vasectomy and vasovasostomy. In fact, 94 % of patients that were under vasectomy for less than 3 years had a positive P34H. The decrease of P34H continues to reach 72 % of positivity between 7 to 9 years after vasectomy. Afterward, P34H was positive in 93% and 100% of vasovasostomized men after 10 to 12 years and 13 to 15 years under vasectomy respectively. CONCLUSIONS: Our results show that a decrease of P34H is associated with the time elapsed between vasectomy and its surgical reversal at least for the first 9 years. After this period, a normal value of P34H characterises a high proportion of vasovasostomized men suggesting an adaptive mechanism within the epididymis. For patients with less then 10 years under vasectomy, the time elapsed between vasectomy and its reversal can be a part of the prognostic factors of fertility recovery in men. Supported by CIHR grants to RS
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