Human Reproduction, Vol. 16, No. 2, 282-288,
February 2001
© 2001 European Society of Human Reproduction and Embryology
Unilateral renal agenesis associated with congenital bilateral absence of the vas deferens: phenotypic findings and genetic considerations
1 Departments of Urology and 2 Pediatrics, and 3 Center for Human Genetics, Boston University School of Medicine, Boston, MA, 4 Reproductive Science Center of Boston, Waltham, MA and 5 University of Medicine and Dentistry of New Jersey, Newark, NJ, USA
An association between congenital bilateral absence of the vas deferens (CBAVD), normal renal anatomy and cystic fibrosis (CF) gene mutations is well established (CF/CBAVD). We postulate that unilateral renal agenesis (URA) and CBAVD (URA/CBAVD) may have a non-CF mutation-mediated genetic basis that leads to abnormal development of the entire mesonephric duct at a very early stage in embryo development (
7 weeks). The physical, laboratory and radiographic findings of men with URA/CBAVD (n = 17) and CF/CBAVD (n = 97) were compared; the fertilization and pregnancy rates in the URA/CBAVD population calculated, and the incidence of renal agenesis in immediate family members and offspring of men with URA/CBAVD analysed. No statistical differences could be identified within any of the above comparisons. The fertilization rate for the URA/CBAVD group was 58.2 ± 26.3%. Eight infants and two fetuses had normal renal anatomy, while one terminated male fetus had bilateral renal and vasal agenesis. Thirty first-order relatives had normal renal units. Anatomical expression of the reproductive ductal derivatives in men with URA/CBAVD and CF/CBAVD was similar, but the phenotypic outcome of the renal portion of the mesonephric duct was different. The potential for transmission of this fatal anomaly reinforces the need for prenatal ultrasounds with all pregnancies involving URA/CBAVD men.
Key words: congenital bilateral absence of the vas deferens/cystic fibrosis/renal agenesis
6 To whom correspondence should be addressed at: DOB Suite 606, 720 Harrison Avenue, Boston, MA 02118-2334, USA.E-mail: robert.oates{at}bmc.org
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