A simple assay for human sperm agglutination antibodies

Safety, tolerance and acceptability of the Invisible Condom® and its vaginal applicator in healthy women and their male sexual partners

OBJECTIVES

The study was conducted to evaluate the safety and acceptability of the Invisible Condom when applied once or twice daily for 14 days in healthy women and their male sexual partners.

STUDY DESIGN

Forty-one women and 23 men divided into three cohorts were enrolled. Cohort 1:14 sexually abstinent women applying gel twice daily for 14 days; Cohort 2:14 sexually active women with tubal ligation applying gel once daily for 14 days and their 14 sexual partners who did not use gel; Cohort 3:13 women on oral contraceptive applying gel once daily for 14 days and 9 of their sexual partners.

RESULTS

No serious adverse events (AEs) were reported. Colposcopy showed no genital ulceration nor epithelial lesions. No major changes in vaginal flora or vaginal pH were detected. None of the women had to stop product application because of AEs. The majority of AEs were mild. Common AEs were itching, dryness, burning sensation, erythema and discharge. Satisfaction questionnaire showed that the gel and applicator were acceptable.

CONCLUSION

The Invisible Condom and applicator were safe, well tolerated and acceptable when applied intravaginally for 14 days. Thus, expanded safety and effectiveness evaluation is warranted.

Safety of protamine sulfate administration in vasectomized men

The majority of vasectomized men develop antibodies against different sperm antigens, including protamine. Due to the fact that salmon protamine is used clinically for heparin reversal and that a cross-reactivity has been observed between human and salmon protamine, vasectomized men may be at risk for adverse reactions to protamine sulfate. In order to explore this possibility, serum samples were analyzed for the presence of anti-sperm and anti-protamine antibodies in 20 vasectomized and 20 non-vasectomized men (controls) about to undergo major heart surgery requiring heparin reversal. The patients were closely monitored for any possible reaction following the injection of protamine. Anti-sperm antibodies were detected in the serum of 15 of the vasectomized men whereas only two of the non-vasectomized subjects had this type of antibody. Twenty-five percent of the vasectomized men presented with anti-protamine antibodies; in the control group, none of the patients had developed this type of antibody. Following the administration of protamine sulfate, none of the patients in either group showed any adverse reaction to the drug. It is concluded that vasectomized men are not at increased risk towards adverse reactions following the injection of protamine sulfate.

Detection and characterization of immune complexes in the circulation of infertile women

The incidence of circulating immune complexes (CICs) was evaluated in sera from 39 female partners of infertile marriages and from 38 fertile women. Fifteen (38%) of the infertile women had CICs, as determined by the Raji cell assay, in levels ranging from 300 to 8000 micrograms/ml; whereas only 1 (3%) of the fertile women displayed CICs (P less than 0.001). Analysis of the CICs from nine of the women following polyethylene glycol precipitation and acid dissociation revealed that four contained C1q and three contained an antigen reactive with rabbit antibody to human spermatozoa. These latter three women all lacked free sperm antibody, as determined by enzyme-linked immunosorbent assay and agglutination. Thus, CICs are not uncommon as a manifestation of infertility in females. Their presence may lead to an underestimation of sperm antibody levels and may be indicative of underlying infection or autoimmunity.