The impact of antisperm antibodies on human infertility

Anti-sperm antibodies detection by a modified MAR test: Towards a better definition of its indications

RESEARCH QUESTION

Anti-sperm antibodies (ASA) have been shown to reduce male fertility but consensus about the precise situations in which tests should be carried out are lacking. In infertility investigations, should the mixed antiglobulin reaction (MAR) test be a first-line test? Should it be carried out systematically before assisted reproductive technology (ART)? What are the risk factors for ASA?

DESIGN

All infertile patients (n = 1364) were tested with SpermMar (modified MAR test) between July 2013 and June 2017. Intra-patient variability of the MAR test was also assesed by comparing two tests within the same year in selected patients (n = 101).

RESULTS

The main factor that influenced the percentage of ASA was the presence or absence of sperm agglutination. In the presence of agglutinations, 27 out of 72 (37.5%) patients were positive for ASA compared with 33 out of 1292 (2.6%) in the absence of agglutinations (P < 0.0001). When one risk factor was present (spontaneous sperm agglutination, history of scrotal trauma or inguinal surgery), 33 out of 179 (18.44%) tests were positive for ASA (≥50% coated spermatozoa), whereas only 27 out of 1242 (2.2%) were positive when no risk factor was present (P < 0.0001).

CONCLUSIONS

ASA detection should not be systematically recommended in investigations of fertility status and before ART but reserved for when sperm agglutination is found during conventional sperm examination, or if the patient has a history of scrotal trauma or has undergone inguinal surgery.

Unexplained male infertility: diagnosis and management

Unexplained male infertility is a diagnosis reserved for men in whom routine semen analyses results are within normal values and physical as well as endocrine abnormalities were ruled out. In addition to erectile problems and coital factors, immunologic causes and sperm dysfunction may contribute to such condition. New etiologies of unexplained male infertility include low level leukocytospermia and mitochondrial DNA polymerase gene polymorphism. Contemporary andrology may reveal cellular and sub-cellular sperm dysfunctions which may explain subfertility in such cases, thus aiding the clinician to direct the further work-up, diagnosis and counseling of the infertile male. The objective of this article is to highlight the concept of unexplained male infertility and focuses on the diagnosis and treatment of this condition in the era of modern andrology and assisted reproductive techniques. Extensive literature review was performed using the search engines: Pubmed, Science-direct, Ovid and Scopus.

TESTICULAR MICROLITHIASIS AND ANTISPERM ANTIBODIES FOLLOWING TESTICULAR BIOPSY IN BOYS WITH CRYPTORCHIDISM

PURPOSE

Testicular biopsy (TBx) performed during orchiopexy in boys with cryptorchidism can help to predict future semen analyses and possibly identify patients at risk for testicular cancer. It has been theorized that TBx can be detrimental to the long-term health of the testis. We examined testicular microlithiasis (TM) and antisperm antibody (ASA) production in cryptorchid TBx.

MATERIALS AND METHODS

A total of 112 males underwent fertility evaluation. These patients had previously undergone orchiopexy and bilateral TBx (mean age 8.6 years) for unilateral or bilateral undescended testis. At a mean age of 19.6 years all patients underwent physical examination and scrotal ultrasound for evaluation of testis size, echotexture and abnormalities. Of 112 patients 57 also underwent direct Immunobead(R) assay with positive controls. Moving sperm free and/or bound to IgG bead complex were counted in the preparation.

RESULTS

A total of 29 patients had bilateral and 83 had unilateral undescended testis. Of the 112 patients 26 were black and 86 were white. Four black patients (15.4%) and 4 white patients (4.7%) had testicular microlithiasis. Three patients had bilateral and 5 had unilateral diffuse TM. No tunica albuginea scars or testis masses were noted. In the 57 patients who underwent direct Immunobead assay no semen sample demonstrated evidence of forming bead-sperm complex, ie none had direct ASA.

CONCLUSIONS

No patient exhibited evidence of direct ASA. Prepubertal open TBx does not increase the rate of TM. We found no evidence of additive testicular damage associated with TBx at the time of orchiopexy.

Clinical Laboratory Evaluation of Male Subfertility

Male subfertility is a common problem with a complex etiology, requiring a complete andrological work-up for proper diagnosis. The male reproductive tract is controlled by a well-balanced hormonal system, in which hypothalamic (GnRH), pituitary (LH, FSH) and testicular hormones (androgens, inhibin B) participate. Any disturbance of this hormonal system may therefore lead to testicular dysfunction and interfere with the spermatogenesis process. In addition, also other components along the ductal system, such as epididymis, prostate and seminal vesicles, that improve sperm fertility by contributing their secretions to the semen, might function inadequately and thus fail to enhance the fertilizing capacity of the sperm cells. External factors (heat, chemicals, life style) and anatomical abnormalities (varicocele) were shown to have a negative influence on male fertility. In a number of patients genetic defects can be identified as the cause of their infertility. Laboratory tests are available to assess hormone concentrations, semen composition, accessory gland function and sperm cell function. Conventional semen analysis includes the determination of sperm concentration, semen volume, sperm motility (qualitative and quantitative), sperm morphology, sperm cell vitality, pH, leucocytes and antibodies. The usefulness of the determination of these parameters as predictor of fertility appears to be rather limited, however. Therefore, alternative tests, some based on more functional aspects (sperm penetration, capacitation, acrosome reaction), have been developed. Furthermore, there is an increasing attention for the assessment of DNA integrity, for instance by the flowcytometer-based Sperm Chromation Structure Assay (SCSA), as an additional or alternative parameter of sperm quality. It is likely and desirable that further assays with better predictive value are being developed in the near future.

Male antisperm antibodies: association with a modified sperm stress test and lipid peroxidation

We previously reported a modified sperm stress test (MOST), low scores (< 0.39) in which were associated with sperm-related abnormal in vitro fertilization. Preliminary observations suggested that the presence of male sperm antibodies (ASA) could give low MOST scores. It was therefore decided to undertake a study to verify this possible association and also to ascertain if such a relationship was causal in nature. Six hundred and fifty semen samples from patients consulting for infertility were assessed for basic seminal characteristics, motion parameters (CASA), ASA and MOST. Thirty-nine samples (6%) were ASA-positive. Samples with and without ASA showed similar characteristics, except for percentage of normal forms and MOST scores (0.35 +/- 0.03 vs. 0.67 +/- 0.01, P < 0.001, for ASA-positive and -negative, respectively). There was a strong statistical association between presence of ASA and low MOST scores (P < 0.0001). One-hundred per cent of ASA-positive samples displayed low MOST scores. To verify the nature of this relationship, we incubated ASA-free spermatozoa with ASA-positive and -negative (control) sera. Despite an increase in the percentage of ASA-bearing spermatozoa in those aliquots incubated with ASA-positive serum, their original (pre-incubation) MOST scores remained unchanged. Furthermore, the rate of lipid peroxidation, indirectly reflected in MOST scores, was not different in the aliquots incubated with ASA. In conclusion, there seems to be a strong association between presence of ASA and low MOST values in semen samples of infertile patients; however, the relationship does not appear to be causal.

Anti-sperm antibodies and seminal characteristics after testicular biopsy or epididymal aspiration in dogs

A study was performed to determine if performing testicular biopsies or epididymal aspirates in dogs would induce sperm-bound anti-sperm antibodies (ASA), affect long-term sperm production or semen quality. Semen was collected from 8 mature dogs 3 times a week before and after hemicastration and then 3 times a week after testicular biopsy (n=3 and 1 control) or epididymal aspiration (n=3 and 1 control). Detection of anti-sperm IgG (ASA) on sperm cells was performed by flow cytometry analysis using a flow cytometer. Two dogs with testicular biopsies became positive for ASA 16 d after testicular biopsy and remained positive for 7 and 9 d, respectively. One dog that had an epididymal aspirate became positive 13 d after epididymal aspiration and remained positive for 35 d. One dog became positive 21 d after hemicastration and remained positive for 28 d. Sperm output declined significantly in 7 of 8 dogs after hemicastration. A control epididymal aspirate treatment dog had decreased sperm output, and a testicular biopsy treatment dog had increased sperm output. None of the dogs with ASA had significant changes in sperm output after treatment. Sperm motility declined significantly in 3 dogs after hemicastration. An epididymal aspiration treatment dog had a decrease in sperm motility, a control epididymal aspirate treatment dog and a control testicular biopsy treatment dog each had increases in sperm motility. None of the dogs with ASA had significant changes in motility. The percentage of normal spermatozoa significantly decreased in 3 dogs and significantly increased in 1 dog after hemicastration. Two dogs that had testicular biopsies and 1 dog that had an epididymal aspiration had decreases in percent normal sperm. Two of 3 dogs with decreases in percent normal sperm after treatment had ASA, but 2 dogs with ASA had no change in motility. Hemicastration, epididymal aspiration, and testicular biopsy can induce ASA production within 2 wk of the procedure, but ASA are transient and do not have a predictably negative effect on total sperm output or motility. Testicular biopsy and epididymal aspiration are safe diagnostic procedures, but further work investigating post-treatment fertility must be done before final conclusions can be made.

Antisperm antibodies: etiology, pathogenesis, diagnosis, and treatment

OBJECTIVE

To critically review the English-language literature and describe the current diagnosis, prevalence, etiology, and treatment of antisperm antibodies (ASA).

DESIGN

A comprehensive literature search of the English-language literature published between 1966 and December 1997 was performed on MEDLINE. Articles were also located via bibliographies of published works.

RESULT(S)

Data were excerpted from articles identified by MEDLINE search. The diagnosis, prevalence, etiology, and treatment of ASA are described.

CONCLUSION(S)

There is sufficient evidence that ASA impair fertility in couples with unexplained infertility. A number of different methodologies are available, which may be used in their detection. However, in many cases, test interpretation is subjective. Although there is not enough evidence to support systemic treatment for ASA, application of a variety of assisted reproductive technologies improves outcome.

Cystic fibrosis and congenital agenesis of the vas deferens, antisperm antibodies and CF-genotype

Antisperm antibodies are formed as a result of vasal and epididymal obstruction. Fourteen males of different ages (pre-, peri- and post-pubertal) with bilateral congenital vasal agenesis and epididymal obstruction secondary to cystic fibrosis (CF), and seven men with congenital bilateral aplasia of the vas deferens (CBAVD) were evaluated with regard to both the presence and levels of serum antisperm antibodies, and the CF-genotype. While IgA and IgG were not detected among pre- and peri-pubertal CF patients, 4 out of 10 (40%) exhibited IgM binding to sperm tail-tip. Post-pubertal CF patients showed high antisperm antibody (ASA) levels in 3 of the 4 males (75%) evaluated for the three isotypes assayed. ASA were found in 5 of 7 CBAVD patients (71%); IgG (n = 3) and IgM (n = 4) were found to be the predominant isotypes bound to sperm tail-tip. CF-genotype analysis revealed two pre-pubertal patients with the DeltaF508/DeltaF508 CF-genotype and a positive ASA response, thus suggesting an earlier or more severe blockage. In addition, the two CBAVD patients found to have a ?/? CF-genotype on the initial screening did not have ASA. The altered antigenicity of sperm associated with initiation of spermatogenesis appears to modify the antisperm antibody isotypes. Further studies on a larger number of patients may allow for a better understanding of the ASA response, as well as a better understanding of a possible phenotype/genotype association between the CF-genotype and the immunologic response.

Treatment of antibody-associated sperm with media containing high serum content: a prospective trial of fertility involving men with high antisperm antibodies following intrauterine insemination

PROBLEM

Antisperm antibodies (ASAs) associated with the sperm surface can significantly influence oocyte fertilization. We initiated a prospective trial comparing the effect of serum-medium dilution on ASA binding and/or distribution following ejaculation and on subsequent pregnancy rates following intrauterine insemination (IUI).

METHOD

Infertile couples (N = 16) were entered into this prospective randomized protocol where the husband's sperm was at least 50% positive for both IgA and IgG ASAs using the immunobead assay. Couples underwent IUI with washed sperm collected during ejaculation into (a) 10 ml of serum medium made up of 50% maternal serum (antibody negative) in Hepes-buffered medium (SM) or (b) in a sterile cup (DRY). For the following cycle, each couple received the alternate sperm treatment. All patients underwent at least two DRY and two SM collections prior to beginning IUI. Sperm from these collections were analyzed by manual semen analysis, computer-aided semen analysis (CASA), and immunobead testing. All sperm preparations for IUI were analyzed by manual analysis and CASA before IUI. Outcome measures were changes in the distribution and amount of sperm antibody binding, sperm motion parameters, and pregnancy rates following IUI. Statistical analysis was performed using Fisher's exact test.

RESULTS

Collection of sperm into SM significantly reduces (P < 0.01) the percentage of antibody-bound sperm (54.8% IgA, 60.0% IgG) versus 83.5% IgA and 87.7% IgG with DRY collection. The distribution or pattern of antibody binding to the sperm also was altered by SM. There was no significant difference between the motility of the sperm following collection with SM or DRY sperm as determined by manual and CASA methods. More importantly, there was no statistically significant difference in the pregnancy rates/treatment cycle following SM (3.1% 32 cycles) or DRY (6.7%, 30 cycles).

CONCLUSION

Our data suggests that SM collection alters immunobead detectable ASA binding. Localization of ASA binding sites suggests that head-bound antibodies are influenced by SM treatment with little effect on tail-bound antibodies. In spite of the significant reduction of ASAs present on the sperm following SM treatment, there was no influence on pregnancy rates.

Risk factors for antisperm antibodies in infertile men

PROBLEM

The prevalence of anti-sperm antibodies (ASAs) in the general population is 0 to 2%; the prevalence in infertile men is much higher at 7 to 26%. However, the role of ASAs in male infertility remains controversial to date. Although several risk factors for ASA development have been defined (such as testicular torsion, varicocele, cryptorchidism, vasectomy, and genital tract infection), there are no specific indications for ASA testing.

METHOD

In order to examine if a single parameter exists identifying patients with elevated ASA titers, serum ASA testing was performed with an enzyme-linked immunosorbent assay (ELISA) in 226 consecutive male patients. The new assay, synchron ELISA (Synelisa) used in our study represents a new type of ELISA without fixation of the sperm surface antigens by formaldehyde or glutaraldehyde. Therefore, the quantitative assay is highly sensitive and reproducible since the structure of sperm surface antigens is not altered by the fixation process.

CONCLUSIONS

The prevalence of ASAs in this population was 14%, while the prevalence of the control group was 2.5%. Of all factors analyzed only a history of vasectomy, an acute epididymitis, and an abnormal result in the bovine mucus penetration test was associated with elevated ASA titers (P < .001). In addition, we could demonstrate a time related formation of ASAs in men after vasectomy.

Varicocele-related infertility is not associated with increased sperm-bound antibody

Immunological factors have been implicated as a cause of unexplained infertility. Previous studies have demonstrated increased levels of sperm-bound antibody in infertile men with varicoceles and have postulated their role in varicocele-related infertility. However, these studies were performed using an enzyme-linked immunosorbent assay. We evaluated retrospectively 111 male patients referred for infertility using a direct immunobead assay. Of the patients 29 had grade II or III varicoceles (that is palpable or easily visualized) and 82 were without varicocele. Four patients who had undergone vasovasostomy were included as controls for the assay. A direct immunobead assay was performed for isotype IgG and IgA sperm-bound antibody using a standard protocol. A computerized semen analysis was also performed. Greater than 20% binding, excluding tail tip activity, was considered significant. Of 29 patients with and 82 without a varicocele significant binding was identified in 5 (17%) and 9 (11%), respectively. Chi-square statistical analysis did not reveal this difference to be significant (p < 0.05). All 4 vasovasostomy patients demonstrated significant binding. We conclude from this study that infertile men with varicoceles do not demonstrate significantly increased levels of sperm-bound antibody compared to infertile controls and, therefore, sperm-bound antibody does not appear to have a significant role in varicocele-related infertility.

Serum antisperm antibodies in men with vas deferens obstruction caused by childhood inguinal herniorrhaphy

OBJECTIVE

To study the incidence of serum antisperm antibodies in patients with vas deferens obstruction caused by childhood inguinal herniorrhaphy.

DESIGN

Retrospective.

SETTING

Kansai Medical University and Kyoto University Hospital.

PATIENTS

Thirteen patients with vas deferens obstruction caused by childhood inguinal herniorrhaphy.

MAIN OUTCOME MEASURES

Indirect immunobead test for serum antisperm antibodies.

RESULTS

Of 13 patients, 7 (54%) and 2 (15%) tested positive for immunoglobulin (Ig)G and IgA class antisperm antibodies, respectively; all patients tested negative for IgM class antibodies. The incidence of antisperm antibodies was not different between the patients with possible epididymal obstruction and those without epididymal obstruction.

CONCLUSIONS

A significant percentage of patients with vasal obstruction caused by infant inguinal herniorrhaphy have serum antisperm antibodies despite the absence of sperm granulomas.

Analysis of human sperm membrane antigens reacting with sera from antisperm antibody positive and negative patients by western blotting

Immunological infertility is thought to be caused by the binding of antibodies to 'fertility-related' antigen(s) on the sperm membrane. We compared antibody profiles in sera from 20 ASA(+) and ASA(-) men, using a sperm membrane extract as an antigen. Antigens were separated by SDS-PAGE under reducing conditions. The patients were classed as ASA(+) by the MAR (> 50%), d-IBT (> 20%) and TAT (> 1:64). The results showed that immunoreactive bands in both the ASA(+) and ASA(-) groups were heterogeneous and included bands covering the whole molecular weight range. Statistical analysis showed significantly more patients in the ASA(+) group having immunoreactive bands at molecular weights of 32 Kd (P = 0.006) and 79 Kd (P = 0.02) when compared to the ASA(-) group. In the ASA(-) group significantly more patients had reactive bands at 81 Kd (P = 0.01) when compared to the ASA(+) group. The 32 Kd antigen reacted only with sera from ASA(+) patients. We conclude that differences exist between the ASA(+) and ASA(-) groups when this extraction method is used and that the isolation and purification of the 32 Kd protein may justify further investigation.

Immunological factors in infertility

Immune infertility can result from destruction of gametes by antisperm antibodies (ASA) or anti-ovary antibodies, by inhibition of sperm-zona pellucida binding by ASA, or by prevention of embryo cleavage and early development. Condoms, immunosuppressive therapy, sperm processing, and intrauterine insemination have been widely applied, but with controversial results.

Antisperm antibodies in the polyglandular autoimmune (PGA) syndrome type I: response to cyclical steroid therapy

OBJECTIVE

To determine if cyclical intermediate dose steroid therapy could improve semen parameters in an infertile man with sperm autoimmunity associated with the polyglandular autoimmune (PGA) syndrome.

DESIGN

Sperm agglutination studies performed before, during and after three courses of cyclical intermediate dose prednisolone therapy.

PATIENT

A twenty-six-year old man with polyglandular autoimmune syndrome, consisting of Addison's disease, hypoparathyroidism, chronic mucocutaneous candidiasis and alopecia totalis, presented with infertility. He had normal endocrine testicular function but severe exocrine failure evidenced by a low sperm count (4.5 x 10(6)/ml), zero motility and universal sperm agglutination.

MEASUREMENTS

Sperm agglutination tests.

RESULTS

At presentation the gelatin agglutination test (GAT) was strongly positive in serum (1/1204) and seminal plasma (1/64) as was the tray agglutination test (TAT) (1/32). The patient's wife had a regular menstrual cycle with normal luteal phase progesterone levels. Following three courses of cyclical prednisolone (20 mg twice daily on days 1-10 of wife's cycle, and 5 mg on days 11 and 12), sperm quantity and motility improved considerably (12 x 10(6)/ml, 40% respectively) and sperm agglutination tests became negative. After a fourth course of therapy the patient's wife became pregnant. Three months post-treatment sperm motility was very low again and agglutinating activity in serum and seminal plasma increased.

CONCLUSIONS

This is the first case of male infertility due to sperm autoimmunity in association with the PGA syndrome type 1. The immunosuppressive action of cyclical intermediate dose steroid therapy led to a significant quantitative and qualitative improvement in semen parameters.

Screening assays for immunologic infertility: a comparison study

Because the immunobead antisperm antibody test (IBT) is difficult to learn and results are heavily operator-dependent, we compared findings on IBT with those of SpermMAR and SpermCheck in 58 patients to determine whether the latter two tests could demonstrate improved screening ability. Assays performed on both sperm and serum (i.e., direct and indirect) yielded 100% positive predictive values when IBT was used as the standard. Both SpermCheck and SpermMAR are easier to perform, and, as the former has a slightly greater sensitivity, we recommend SpermCheck for the detection of immunologic infertility.

Unilateral childhood ovarian loss: an indication for contralateral oophoropexy?

A 35-year retrospective review of all surgically significant pathological lesions of the ovary was conducted. Fifty-one children had 53 ovarian lesions which required surgical intervention. Of the 53 ovarian lesions seen in this series, 21 had presented with torsion. Five of these torted ovaries were microscopically normal. Three children were castrated. One of these castrations could have been prevented if contralateral oophoropexy was done. In addition, one child, who had lost an ovary previously because of torsion, presented with major cystic disease of the remaining ovary. Torsion was aborted by ovarian cystectomy. Contralateral oophoropexy at the time of ipsilateral oophorectomy is recommended to prevent castration.

The effects of testicular trauma on fertility in the Lewis rat and comparisons to isoimmunized recipients of syngeneic sperm

Adult male Lewis (LEW) rats were used to investigate the effects of unilateral testicular trauma on fertility. Comparisons were made between normal and experimental rats immunized with syngeneic sperm in Complete Freund's Adjuvant (CFA). Matings within the three groups yielded offspring to all normal males, no offspring to the immunized rats, and 27% (3/11) fertility in the trauma group (p less than 0.001). The contralateral testis demonstrated decreased volumes, various degrees of aspermatogenesis and smaller seminiferous tubular diameters, in both the trauma and immunized groups compared to the controls. Similar histopathologic findings of chronic granulomatous inflammation within contralateral testes in both the trauma and immunized groups suggested a common immune etiology for infertility via possible disruption of the blood-testis barrier.

Intrauterine inseminations with washed human spermatozoa does not induce formation of antisperm antibodies

In this study we investigated the possible development of serum antisperm antibodies in women receiving repeated IUI. Patients acted as its own control and were evaluated before and after various (1 to 15) IUI cycles using three different assays for antisperm antibodies. It was found that only 2 out of 41 women developed antisperm antibodies. We concluded that exposure of the upper reproductive tract to washed spermatozoa during repeated IUI with partners' sperm does not significantly stimulate the appearance of serum antisperm antibodies.

SpermCheck: a simplified screening assay for immunological infertility

SpermCheck (Bio-Rad Laboratories, Hercules, CA), a new screening test for regional surface antibodies on motile sperm, uses monodispersed latex microspheres of uniform size as a vehicle to link rabbit antihuman immunoglobulins (IgA, IgG, IgM) and provides both negative and positive control sera, as well as sufficient buffer for sperm preparation in ambient CO2 atmosphere. When compared with reference data available for the immunobead test (IBT), the direct protocol (semen) for SpermCheck yielded 94.4% sensitivity with 100% specificity; the indirect protocol (serum) provided a sensitivity of 100% with 94.7% specificity. The microspheres of SpermCheck maintain a nearly uniform concentration per volume, with none to negligible clumping. The greater difference between the optical densities of latex and cytoplasm allows use of a light microscope for the rapid assessment of the percent of regional binding rather than the phase-contrast microscope required for the IBT. SpermCheck eliminates many difficulties encountered with the IBT, making SpermCheck a convenient screening assay for use in the physician's office.

Use of specific monoclonal antibodies to secretory IgA for the detection of spermatozoal antibodies in serum and seminal plasma by enzyme-linked immunosorbent assay

The role of anti-sperm secretory IgA has recently received attention since some workers feel it plays an important role in the prognosis of the immunologically infertile couple. Current methods used in our laboratory cannot separately detect anti-sperm secretory IgA. An enzyme-linked immunosorbent assay (ELISA) utilizing specific monoclonal antibodies to secretory IgA was used to detect anti-sperm secretory IgA as well as anti-sperm monomeric IgA and IgG in serum and seminal plasma of a sperm-antibody-positive (ASA+) and sperm-antibody-negative (ASA-) group of men. Results showed significantly raised serum levels in the ASA+ group when compared to the ASA- group for anti-sperm secretory IgA (P less than .001), anti-sperm monomeric IgA (P less than .001), and anti-sperm IgG (P less than .01). Seminal plasma levels were also raised in the ASA+ group, but only significantly so for monomeric IgA (P less than .02). The performed ELISA has definite potential in research, especially with the use of monoclonal antibodies for the detection of anti-sperm secretory IgA, but cannot as yet be used as a prognostic predictor of fertility in the individual antibody-positive patient. Infertility specific antigens will have to be identified and isolated and subsequently used in the ELISA.

Antisperm antibodies are more prevalent in men with low sperm motility

Fifty-six men with low sperm motility (less than or equal to 40% of sperm with forward progression) who attended our infertility clinic were tested for antisperm antibodies (IgG and IgA) using the indirect immunobead test. Nineteen (34%) of these men were found to be positive (greater than 10% binding). This was significantly higher (P less than 0.01) than the incidence (5%) of antibodies in men who attended our infertility clinic with high sperm motility (greater than 40% of sperm with forward progression). It is concluded that significantly more men with low sperm motility have antisperm antibodies. The functional significance of these antibodies warrants further investigation.

Antisperm antibody tests: traditional methods compared to ELISA

Enzyme-linked immunosorbent assays (ELISAs) to detect sperm antibodies can be a useful addition to other tests. ELISAs allow more quantitative and detailed information than some other tests, but results should be compared to those of other tests. This study was conducted to correlate results of an ELISA that used a sperm membrane extract as antigen with those of other tests. Semen, seminal plasma, and serum of 34 sperm-antibody-positive and 36 sperm-antibody-negative men were tested. There was poor correlation between the ELISA results and those of the other tests. Only the results of a direct immunobead test done on semen correlated fairly well with results from ELISAs done on serum. Further studies are needed on fertility-specific antigens that can be identified and isolated and then studied by means of ELISAs.