Significant immunologic factors in male infertility

Area of Science:

• Immunology
• Reproductive Medicine
• Andrology

Background:

• Involuntary infertility affects numerous couples, with a subset exhibiting sperm antibodies in their serum.
• Immunological infertility, characterized by the presence of sperm antibodies, is a recognized factor contributing to conception difficulties.
• Sperm antibodies are also observed in cases of necrospermia and in a significant percentage of vasectomized men.

Purpose of the Study:

• To investigate the prevalence of sperm antibodies in infertile populations.
• To evaluate the efficacy of corticosteroid immunosuppression as a treatment for immunological infertility.
• To determine the potential for pregnancy following immunosuppressive therapy.

Main Methods:

• Sperm antibody detection using two distinct sperm agglutination techniques: the Kibrick method (gelatin agglutination) and the F-D method (tube-slide agglutination).
• Administration of a 7-day regimen of methylprednisolone (96 mg/day) for immunosuppression.
• Monitoring of antibody levels and pregnancy outcomes in treated couples.

Main Results:

• The Kibrick method identified positive sperm antibody results in 9% of men and 18% of women from infertile couples.
• The F-D method indicated positive results in 5% of men and 15% of women.
• Treatment with methylprednisolone led to a notable decrease in sperm antibody levels in some patients, with approximately a 30% success rate in achieving pregnancy among 15 couples.

Conclusions:

• Sperm antibodies are a relevant factor in a portion of involuntary infertility cases.
• Corticosteroid therapy, specifically methylprednisolone, shows promise in reducing sperm antibody levels and improving fertility outcomes.
• Immunosuppression represents a viable therapeutic strategy for immunological infertility, with a demonstrated potential for successful pregnancies.