Male Antisperm Antibodies Research Articles

Possible risk factors for the formation of antisperm antibodies in a subfertile population

<strong>Objectives: </strong>1. To investigate the incidence of antisperm antibodies (ASA) in a subfertile population in a Sri Lankan set up. 2. To determine the possible risk factors for the formation of ASA among them. <strong>Methods: </strong>A prospective descriptive study was carried out on subfertile couples treated at 'Prarthana', Centre for ART, during the period from 01.01.2006 to 01.01.2009. A total of 230 couples were included. Using an investigator administered questionnaire following information was obtained for each subject &ndash; demographic details, medical, surgical histories, genito-urinary infections, illnesses and medications, social habits etc. Presence of ASA was elicited using mixed antiglobulin reaction latex bead test (SpermMAR, Fertipro NV, Belgium) on spermatozoa, seminal plasma and serum of males and cervical mucus, serum and follicular fluid of females. <strong>Results: </strong>Out of 230 couples, 48 (20.86%) were positive for ASA. There were no significant associations observed between the presence of ASA and age, duration of marriage/subfertility, occupation, type of subfertility, associated autoimmune diseases, illnesses, and use of addictables in both males and females. Of the seven males who had undergone genital surgeries two were positive for ASA (Chisq= 4.407, P-value=0.036). A proportionately higher incidence of ASA was observed in females (11.7%) who had previous intra-uterine insemination (IUI) compared to females who did not have IUIs (5.88%). Markedly higher association of ASA was observed in females with pelvic inflammatory disease (PID) (20%) than PID free females (8%). <strong>Conclusion: </strong>Genital surgeries of men play a significant role in formation of ASA in males. Females who have undergone IUIs and who have had episodes of PID are at a greater risk in developing ASA. <strong>Key words: </strong>antisperm antibodies; incidence; risk factors. DOI: <a href="http://dx.doi.org/10.4038/sljog.v33i1.3998">http://dx.doi.org/10.4038/sljog.v33i1.3998</a> <em>SLJOG </em>2011; 33(1): 12-19<strong><em></em></strong>

ORIGINAL ARTICLE: Incidence of Antisperm Antibodies in Males with Systemic Autoimmune Diseases

Problem To investigate if systemic autoimmune diseases could be one of the risk factors for developing antisperm antibodies (ASA) in males.Method of study Antisperm antibodies in the sera of 70 males with systemic autoimmune diseases and 80 healthy controls were examined, by using the indirect‐immunobead test (I‐IBT). The sperm immobilization test (SIT) was also performed to detect sperm immobilizing antibodies to the patients who were positive in I‐IBT.Results Among 70 males with systemic autoimmune diseases, five were I‐IBT positives, with incidence of 7.1%. However, no positives existed in 80 healthy males. Compared with the healthy controls, the incidence of ASA in males with systemic autoimmune diseases was significantly higher (P = 0.020). None of these five ASA‐positive patients had sperm immobilizing antibodies.Conclusion The incidence of ASA in males with systemic autoimmune diseases was significantly higher than in the healthy controls. Systemic autoimmune diseases may be one of the risk factors for developing ASA in men.

Diagnosis and treatment of immunologically infertile males with antisperm antibodies.

The presence of antisperm antibodies (ASA) can reduce fecundity in both males and females. The present review describes a strategy, established by investigations of the diverse inhibitory effects of ASA on fertility, for the appropriate diagnosis and treatment of infertile males with ASA. For infertile males with ASA, diagnosis using the direct-immunobead test (D-IBT), the postcoital test (PCT) and the hemizona assay (HZA) should be carried out as the basis for decision-making. If the patient with ASA has an abnormal hemizona index, it seems reasonable to advise selecting intracytoplasmic sperm injection-embryo transfer (ICSI-ET) as a primary treatment. However, it has been shown that some immunologically infertile males with normal fertilizing ability established pregnancy by timed intercourse (TI) or intrauterine insemination (IUI). In such patients with ASA having normal hemizona index, TI or IUI can be selected based on the PCT result. Therefore, the treatment strategy for males with ASA is similar to that for infertile males with oligozoospermia or asthenozoospermia. In conclusion, it should be emphasized that a diversity of ASA exists and their effects on fertility in infertile males. Although there is an argument that routine testing for ASA in males is not always necessary, one should be aware that in some cases of failed IUI or IVF, ICSI is selected afterward because of the diagnosis of ASA. (Reprod Med Biol 2005; 4: 133-141).

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.

Effect of antisperm antibodies on postcoital results and effect of intrauterine insemination on pregnancy outcome.

The effect of antisperm antibodies (ASA) in males was determined in 59 men using the direct immunobead test (IBT). Postcoital tests were evaluated in couples for whom all female factors appeared to be corrected. Pregnancy rates in 6 months were compared in couples with good postcoital tests vs. those with poor results; the latter group was treated with timed intrauterine insemination (IUI). Thirty-one percent of males with positive ASA (greater than or equal to 50%) had normal postcoital tests and all four achieved pregnancies. Fifty-six percent of men with positive ASA and poor postcoital scores achieved pregnancies following IUI therapy of their wives in 6 months; 83% of couples with normal postcoital tests achieved pregnancies as did couples treated with IUI when the postcoital was poor but the male ASA negative.