The use of antibodies developed by infertile women to identify relevant antigens

In the first half of this century several studies demonstrated that temporary infertility may be induced by immunizing women with semen. Isolated examples of acute hypersensitivity reactions to sexual intercourse provide dramatic evidence that natural isoimmunization to semen occurs in man. The afferent immunological pathway in this process can be influenced by adjuvant effects of genital tract infection. This may be important in assessing the significance of antisperm antibodies in infertile women. In immunological studies of female infertility, the 3 most commonly used tests for humoral antisperm activity are microagglutination, macroagglutination and immobilization (complement dependent cytotoxicity). The sperm microagglutination test detects both antibody and non-antibody activity. The macroagglutination and immobilization tests both detect antibodies but to date the latter has provided the more meaningful results in infertile women. A prospective study of reproductive patterns in infertility patients indicated a lower subsequent fertility rate and a markedly higher abortion rate in women with antisperm antibodies compared to those without them. However, the association of antisperm antibodies with continuing infertility only reached a statistically significant level in women with a past history of unexplained infertility of at least 3 years' duration. Occlusion (condom) therapy in patients with antisperm antibodies has proved unsuccessful when compared with the natural reproductive patterns in untreated patients. Immunofluorescence studies are described and correlated with results of other tests for antisperm antibodies in serum and cerivcal mucus. The results of these and of other studies of naturally occurring antibodies in infertile women have identified antigens of actual or potential relevance to infertility and fertility control. These include (i) intrinsic spermatozoal antigens, (ii) seminal plasma antigens, (iii) blood group antigens, (iv) histocompatibility antigens and (v) nucleoprotein antigens.