ATF4 and congenital bilateral aplasia of vas deferens from CFTR mutation: Herein, we attempted to investigate the role of OxPL in CAVD by regulating ATF4, and the current findings unveil that OxPL can potentially up-regulate the expression of ATF4, thus promoting LPS-induced M1 polarization of macrophages, enhancing the osteogenic differentiation of VICs and formation of AVC, and eventually leading to the initiation of CAVD.