The clinical significance of antisperm antibodies in male subfertility

Abstract

Sera from 591 men attending Fertility Clinics have been tested for agglutinating, immobilising and immunofluorescent antisperm antibodies. There was good correlation between the presence of high titres (more than 1/32) of agglutinating and immobilising antibodies which were found in 50 patients (8.5%). 27 of these men had normal sperm counts, but crossed hostility testing showed that in 21 of 22 couples the sperms were unable to penetrate the cervical mucus, apparently because of the antibodies. 17 patients were treated with prednisone for an average of 6 months and 1 pregnancy was produced. 17 patients were treated with methylprednisolone for 7 days and 1 pregnancy resulted. No correlation was found between the present of immunofluorescent antibodies and the other antibodies of impaired sperm penetration of cervical mucus.

PIP: Between September 1975-March 1977, sera from 591 men attending the Fertility Clinic at Chelsea Hospital in London were tested for agglutinating, immobilizing, and immunofluorescent antisperm antibodies. The 3 techniques used to test are described. Results of the testing were correlated with the patients' clinical state and findings on seminal analysis. When antisperm antibodies were found, the behavior of the husband's sperm was studied in the cervical mucus of his wife. This result was compared with behavior of donor sperm with no antisperm antibodies and with donor cervical mucus. Test data indicate that high titers of immobilizing and agglutinating antibodies did prevent the sperm from effectively penetrating cervical mucus. This was not true with antibodies detected by immunofluorescent techniques. The crossed hostility testing is necessary in cases of marital infertility to identify which partner in the marriage has the antibodies. Treatment for infertility resulting from antisperm antibodies is steroid therapy combined with sperm washing and insemination.