Assessing immunity to sperm

Immunological factors are now recognized to operate in a proportion of infertile couples. The assessment of immunity to sperm has been a difficult exercise due largely to the technical vagaries of some of the tests employed and to uncertainties about the biological significance of antisperm antibody activity demonstrated in vitro. This paper reviews the currently available test systems and foreshadows the development of more sensitive and specific assays using defined antigens, particularly those derived from the cell membrane of sperm. It is now clear that the comprehensive assessment of sperm immunity as a potential influence on fertility should include a spectrum of tests designed to detect both local and systemic antibodies in each partner.