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Abstract
BackgroundCongenital bilateral absence of the vas deferens (CBAVD) is a rare condition associated with male infertility. CBAVD is often accompanied by other genitourinary anomalies, including abnormalities or agenesis of the seminal vesicles and kidneys. While it is expected that CBAVD always coexists with seminal vesicle agenesis due to a shared embryologic origin, some studies report the presence of seminal vesicles in certain CBAVD patients. This study aims to assess the status of seminal vesicles in CBAVD patients and explore the relationship between seminal vesicle presence and semen parameters.MethodsIn this multi-center, retrospective cross-sectional study, we reviewed data from 47 CBAVD patients diagnosed between 1994 and 2024. Data collected included demographic information (age, height, weight, BMI), physical examination findings (vas palpation), and imaging results (trans-rectal ultrasound for seminal vesicle status, abdominal and pelvic ultrasound for kidney status). Laboratory data included serum FSH, LH, and testosterone levels, as well as semen analysis results (pH, fructose, and volume). Patients were classified into three groups based on seminal vesicle status: bilateral agenesis, unilateral agenesis, and bilateral presence.ResultsAmong the 47 CBAVD patients, 29 had bilateral agenesis of the seminal vesicles, 9 had unilateral agenesis, and 9 had bilateral presence. No significant differences were found between the groups regarding weight, height, BMI, or serum levels of LH, FSH, and testosterone. Additionally, semen analysis revealed that 89.4% of patients had abnormal pH, 93.6% had abnormal volume, and all patients had abnormal semen fructose. There were no significant differences between the groups in semen pH, fructose, or volume.ConclusionOur findings suggest that the presence or absence of seminal vesicles in CBAVD patients does not significantly affect semen parameters. This may be due to dysfunction of the seminal vesicles in those with a present organ.
Highlights
Congenital bilateral absence of the vas deferens (CBAVD) is a rare anomaly and is the cause of around 1–2% of infertility cases [1]
No significant differences were found between the groups regarding weight, height, BMI, or serum levels of luteinizing hormone (LH), follicle stimulating hormone (FSH), and testosterone
Our findings suggest that the presence or absence of seminal vesicles in CBAVD patients does not significantly affect semen parameters
Summary
Congenital bilateral absence of the vas deferens (CBAVD) is a rare anomaly and is the cause of around 1–2% of infertility cases [1]. It is expected that CBAVD is associated with seminal vesicle agenesis in all patients due to their common embryologic origin. There are studies that report some CBAVD patients with present seminal vesicles [8–10]. Jarvi et al indicated that abnormality in the distal wolffian duct structures, such as the ampulla of the vas deferens and seminal vesicles, is dependent on the CFTR genotype as half of the patients with CBAVD who do not carry any CFTR mutations present with bilateral presence of seminal vesicles [11]. Congenital bilateral absence of the vas deferens (CBAVD) is a rare condition associated with male infertility. While it is expected that CBAVD always coexists with seminal vesicle agenesis due to a shared embryologic origin, some studies report the presence of seminal vesicles in certain CBAVD patients. This study aims to assess the status of seminal vesicles in CBAVD patients and explore the relationship between seminal vesicle presence and semen parameters
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