Historical Background of Immune Infertility Associated with Anti-sperm Antibody (ASA) in Men

Abstract

AbstractAnti-sperm antibodies (ASAs) can be located on the surface of sperm and are also detected in seminal plasma and serum in infertile men. Several authors reported the conflicting relationship between ASA and male infertility from the middle of the 1950s to the beginning of the twenty-first century.We investigated the reasons for such a confusion. Finally, we found that there was a diversity of ASA, which caused the misunderstanding of the clinical significance of the antibodies in men. For example, some of the sperm-bound antibodies are associated with complement-dependent sperm-immobilizing antibodies, indicating that there exists a heterogeneity of sperm-bound antibodies. Therefore, we offered that the ASA testing should be carried out as a routine test for the appropriate diagnosis of immunological infertility in men. There is no doubt that the most useful diagnostic method for detecting ASA is one that can assess the antibodies on the surface of ejaculated sperm.For the appropriate diagnosis of immunological infertility in males, the direct immunobead test (IBT) or the mixed antiglobulin reaction (MAR) test should be carried out as a routine test in the infertility clinic. Then, post-coital test (PCT) and the hemizona assay (HZA) should be carried out as an initial screening in infertile men with ASA and used as the basis for decision-making.