Autoimmunity in Endocrine Disease

Abstract

In general there is a parrallel between serum sperm agglutinin titers and the inability of the spermatozoa to penetrate the cervical muscosa. The serum of 67 (3.3%) of 2015 infertile males had titers of 1:32 or higher. Of 416 fertile men and 124 infertile women none had serum with titers of 1:32 or higher. Of the 67 infertile men about 1/3 had semen with normal sperm density and usually autoagglutination; another third had oligospermia with sperm of subnormal motility while autoagglutination was not easily observed; and the remaining third had azoospermia usually due to obstruction of efferent ducts. Of the last group testis biopsies showed normal histology in 15 men and partial abnormality in 2 indicating that sperm autoantibodies did not interfere with spermatogenesis. No cause for antibody formation was observed in more than half of nonazoospermic patients. There was a positive correlation between agglutination and staining of ejaculated spermatozoa by an indirect immunofluorescent antibody technique. Some sera stained both testicular and ejaculated spermatozoa and some only one or the other. Five of 11 men with congenital absence of both the vasa deferentia and seminal vesicles had sperm agglutinins at titers of 1:8 to 1:256 higher levels of gamma A (P=.004) and higher titers of complement-fixing anti-measles virus antibodies (P=.008) than those without sperm agglutinins. Among 25 men whose vasa had been ligated 2 to 20 years previously 17 showed no sperm agglutinins perhaps due to: 1) a variable mechanism of phagocytosis and/or defective digestion of spermatozoa by cells lining the sperm pathway 2) resorption of sperm antigens causing immune tolerance 3) initiation of antibody formation requiring an adjuvant inflammatory effect 4) other antibodies. Corticosteroid and ACTH therapy has not altered the serum titers or autoagglutination of infertile men.