Immunologic considerations before and after vasovasostomy

A prospective study has been completed to determine the incidence and significance of antisperm antibodies in 160 men undergoing vasovasostomy to relieve obstruction of the vas deferens due to vasectomy. Preoperatively, serum sperm-agglutinating antibody (SSAA), serum sperm-immobilizing antibody (SSIA), and seminal plasma sperm-agglutinating antibody (SPSAA) were found in 63%, 37%, and 3%, respectively. When they were postoperatively studied, 92 of the same men demonstrated no significant change in the incidence or the absolute level of SSAA or SSIA. The SPSAA was found in 7% of 120 men preoperatively; however, 16% of 51 men studied postoperatively exhibited SPSAA. Significant differences in pregnancy rates have been documented between the spouses of men with detectable levels of agglutinating and immobilizing antibody and the spouses of men with no evidence of antibody formation.