Orphanet: Congenital bilateral absence of the vas deferens (CBAVD) is a condition
leading to male infertility. It accounts for 6% to 8% of cases of
obstructive azoospermia and affects about 1/1,000 males. It is also
found in 98% of males with cystic fibrosis.
Infertile patients with
CBAVD produce small volumes of acidic sperm (<1 ml with a pH<7.0).
The condition is transmitted as an autosomal dominant trait. In 1990,
mutations in the CFTR gene (the
causative gene for cystic fibrosis) were identified in 42% of patients
in a population of infertile males with CBAVD, suggesting that CBAVD is a
genital form of cystic fibrosis. Since then, an exhaustive analysis of
the 27 exons of the CFTR gene has led to the classification of CBAVD patients into four groups: i) patients with two mutations in the CFTR gene (19%), ii) patients with one mutation in the CFTR gene and having the IVS8-5T allele in the trans position (33%), iii) patients with either a mutation in the CFTR gene or having the IVS8-5T allele (27%) and iv) patients with neither the IVS8-5T allele nor a mutation in the CFTR
gene (21%). These data have important implications for genetic
counselling: the method of intracytoplasmic microinjection of a single
spermatozoon has successfully resolved the male infertility problem.
However, the identification of a CFTR mutation in a CBAVD patient implies that a CFTR
mutation in the patient's partner should be sought, as if a mutation is
found, preimplantation or prenatal diagnosis can be proposed.