Significance of sperm antibodies in human fertility

Abstract

Indirect immunofluorescent, macroagglutination and immobilizing sperm antibody estimations were performed as part of a prospective study on a representative group of 63 infertile couples. Serum from both, cervical mucus and seminal plasma were tested and the clinical use of the tests evaluated by considering the pregnancies that occurred and the causes of infertility that were discovered in the subsequent year. The indirect immunofluorescent test had the largest number of positives although more were found in seminal plasma than elsewhere. In these, both male and cervical factors were implicated and in this media there were less positives pregnant with the acrosome and midpiece patterns absent. The macroagglutination test had no positives pregnant and again more significance was attached to positives in the male. Similarly, immobilization results showed most positives in seminal plasma where the male and cervical factors featured prominently. It would, therefore, appear that if any clinical use is to be derived from the three tests in the search for antisperm antibodies as a cause of infertility, testing the male and especially seminal plasma appears to correlate best. If treatment is to be recommended, therefore, it should be concentrated on the man.

PIP: The significance of sperm antibodies in human fertility was investigated. Indirect immunofluorescent, macroagglutination, and immobilizing sperm antibody estimations were performed as part of a prospective study on a group of 63 infertile couples. The clinical use of the tests was evaluated by considering the pregnancies that occurred and the causes of infertility that were discovered in the subsequent year. The indirect immunofluorescent test showed more positives in seminal fluid (1/3) than elsewhere, although in 62% of the couples at least 1 of the media tested was positive and in 14.3% something was positive in both partners. Both male and cervical factors were implicated, and in this media there were less positives pregnant with the acrosome and midpiece patterns absent. No pregnancies were involved in the positives of the macroagglutination test; in the 3 cases where the male was involved, the cause was asthenozoospermia. The immobilization results showed the greatest number of positives in seminal plasma with male and cervical factors featured prominently. In this group pregnancy was achieved when ovulation was stimulated. It appears that if a clinical use is to be derived from these tests in the search for antisperm antibodies as a cause of infertility, testing the male, and especially seminal plasma, appears to correlate best. If treatment is recommended, it should be for the man.