Postcoital tests and sperm-agglutinating antibodies in men

Normal fertilization in men with high antibody sperm binding by the addition of sufficient unbound sperm in vitro

A high incidence of fertilization failure has been reported in men with over 70% of their sperm bound with isoantibodies. In three men with greater than 80% antisperm antibody binding with IgG and IgA immunoglobulins, a normal rate of fertilization (29/46 oocytes; 63%) was achieved by adding a sufficient number of motile sperm to provide at least 50,000 unbound sperm per oocyte. This method appears to be simpler and more effective than attempting to separate unbound sperm in vitro.

Quantitation of sperm bindable IgA and IgG in seminal fluid

Seminal fluid and serum from 95 infertile males were assayed for sperm bindable immunoglobulins using an indirect ELISA with whole target sperm. The ELISA method was compared to seminal fluid and serum immobilization and agglutination assays (functional assays). In this infertile group, the ELISA assay was positive in 22% of seminal fluids (greater than 1.2 fg IgA/sperm and greater than 0.3 fg IgG/sperm). The seminal fluid antibodies were IgA and had an accompanying elevated IgG component in 78% of patients. There was a 96% correlation between negative seminal fluid functional assays and negative ELISA, and a 95% correlation between positive seminal fluid functional assays and positive ELISA. Positive serum sperm antibody tests were found in 71% of the infertile males with positive seminal fluid sperm antibodies, but 29% of the infertile males with strongly positive IgA seminal fluid sperm antibodies showed normal levels of serum sperm antibodies by either ELISA or functional assays. The ELISA method gives reproducible quantitation of sperm antibodies in seminal fluid and correlates well with accepted functional assays. Comparisons with serum sperm antibody assays suggests that seminal fluid sperm antibody analysis complements the serum analysis of sperm antibodies.