Cystic fibrosis (CF) is a genetic disease that affects multiple organ systems from the digestive tract to the lungs. In men, CF causes the vas deferens to atrophy early in embryologic development. Therefore, men with CF are born without a vas deferens. Doctors term this condition congenital bilateral absence of the vas deferens (CBAVD.) The vas deferens is a paired sperm tube that transports sperm from the testicles to the ejaculatory duct. If a man has no vas deferens, sperm is trapped in the testicle, actually the epididymis, the gland that stores sperm prior to ejaculation.
The good news about CF is these men are living longer, well into reproductive age, and therefore many have the desire to become fathers. Also, sperm production in men with CF tends to be normal. They therefore have obstructive azoospermia. One of the tricky things about the CF gene is that not all men have the severe manifestations of the disease. There are in fact many men that have none of the respiratory or digestive symptoms of CF. Often, the only symptom these men have is absent vas deferens.
As of now, there is no artificial vas deferens that we can surgically implant in men to transport sperm from the epididymis into the ejaculatory duct. Therefore, men with CF will need to undergo surgical extraction of sperm to be used for in vitro fertilization (IVF). Surgical extraction of sperm is referred to as microsurgical epididymal sperm aspiration (MESA). Once the surgeon extracts the sperm, those sperm will be processed and selected to implant directly into the partner’s harvested egg. Because CF is a genetic disease, it’s critical the female partner also gets tested for the gene and appropriate genetic counseling is offered.
Board-certified urologists staff The Men’s Clinic at UCLA and you can be assured you are getting an experienced physician performing your evaluation and procedure in a relaxed and comfortable environment. For more information and to schedule an appointment, please call the UCLA Urology Appointment line at (310) 794-7700.