The role of the epididymis in human infertility

This review describes the role of the epididymis in human infertility, by a nalysing the results of epididymovasostomies which confirm that the more di stal the site of obstruction the greater the chance of fertility. The use o f epididymal spermatozoa for in vitro fertilization (TVF) yielded poor resu lts in contrast to intracytoplasmic sperm injection using either epididymal or testicular spermatozoa. The nature of the pathology causing obstructive azoospermia is examined reviewing in particular the possible role of mercu ry toxicity in Young's syndrome. This review describes the results of studi es that show that the level of obstruction within the epididymis is correla ted with the presence of sperm antibodies and distal obstructions are assoc iated with the presence of sperm antibodies. The demonstration that necrozo ospermia decreases with increased sperm transport through the epididymis, w hen combined with the observation of normal testicular sperm morphology, re presents the basis for the disorder termed epididymal necrozoospermia. Howe ver, to date the nature of the epididymal pathology causing this disorder r emains obscure.