Epididymal abnormalities associated with sperm obstruction

Abstract

The testicular descent process is a complex event, occurring defectively in 1% to 4% of full- term newborn boys and 1% to 45% of preterm newborns (1). Cryptorchia is a common genital anomaly not fully understood. Much has been studied on the histological development of cryptorchid testes with many previous publications. More than 40 years ago, germ cell counts, and the analysis of spermatogonial development associated the cryptorchidism to male fertile potential, with strong data showing that abnormal germ cell development is often present (2). In addition, anomalies of the epididymis, vaginal process and gubernaculum have been reported with a potential impact on fertility, especially regarding the anatomical relationship between the epididymis and the testis. This may be abnormal in boys with cryptorchidism (3), but the reported frequency ranges widely from 16% to 75% probably because this anomaly is difficult to be characterized and classified (4, 5). In this context, which criteria, then, related to the patterns of epididymal anomalies, would be associated with a possible obstruction, thus impacting fertility?