Zirkulierende Sperma-Antikörper im Serum - Vergleich verschiedener Kollektive

Abstract

The clinical significance of circulating antisperm antibodies (ASA) during infertility investigation is controversial. For detection of ASA in serum, enzyme-linked immunosorbent assays (ELISA) are widely used because of practical advantages. In the present prospective study, the prevalence of serum ASA, determined with a commercially available ELISA (Elias Inc., Freiburg) was compared in different groups: in a total of 260 subfertile patients (148 women and 112 men) with a median duration of infertility of five years, and in 190 controls (69 normal pregnant women who presented for routine pregnancy care, 41 virgins and 80 prostitutes). Evaluation of serum samples in the different groups offered median ASA-values of 11.9 U/ml in women with long-standing infertility, of 9.6 U/ml in subfertile males, of 10.6 U/ml in the normal pregnant women, of 12.2 U/ml in virgins and of 10.0 U/ml in prostitutes. Differences between patients and controls were not significant. When a cut-off at > 25 U/ml was used for definition of positivity, this ELISA revealed that 18.2% of the female and 15.2% of the subfertile male patients were ASA positive, and within the control groups, 11.6% of the normal pregnant women, 14.6% of the virgins and 21.3% of the prostitutes (not significant, also with regard to other cut-offs). Within the group of subfertile patients, no significant differences were found between ASA-positive and -negative patients with regard to medical history, results of clinical examination, causes of infertility, microbial colonisation, of genital secretions, outcome of sperm analysis, postcoital testing (PCT), and crossed in-vitro sperm cervical mucus penetration testing (SCMPT). Pregnancies were achieved within three months without any therapy in spite of high ASA-titres. The results of this study demonstrate that evaluation of serum samples of subfertile patients for antisperm antibodies by means of this commercial ELISA is without clinical relevance and cannot be recommended during infertility investigation.