Anti-sperm Antibody Positivity in Men with Varicocele: A Systematic Review and Meta-Analysis

Area of Science:

• Reproductive Immunology
• Urology
• Male Infertility

Background:

• Varicocele is a known factor in male infertility pathogenesis.
• The association between varicocele and anti-sperm antibodies (ASA) requires further clarification.

Purpose of the Study:

• To systematically review and meta-analyze the frequency of ASA positivity in men diagnosed with varicocele.
• To compare ASA prevalence in varicocele patients versus control groups.

Main Methods:

• Systematic review and meta-analysis adhering to MOOSE guidelines.
• Literature search conducted on Scopus and PubMed databases.
• Extracted data on ASA positivity in ejaculates or serum using MAR assay, immunobead tests, and ELISA.

Main Results:

• Meta-analysis of 6 studies revealed higher ASA positivity in varicocele patients across different testing methods.
• MAR assay showed 39.8% ASA positivity in varicocele vs. 17% in controls (OR=4.34).
• ELISA indicated 37.1% serum ASA positivity in varicocele vs. 15.8% in controls (OR=7.87).

Conclusions:

• ASA positivity is significantly elevated in men with varicocele.
• Findings suggest an underlying immunological pathology contributing to infertility in varicocele patients.
• Results may inform future management strategies for infertile men with varicocele.