Office based screening of sperm autoimmunity

Sperm autoimmunity has been reported as a contributory cause of male factor infertility in up to 10% of subfertile men. The standard laboratory technique for the determination of sperm bound antisperm antibodies is the direct immunobead test. However, because of its complex methodology this test does not readily lend itself as a screening tool for this diagnosis. We describe a simple office based procedure, the sperm mixed antiglobulin reaction, for the detection of antisperm antibodies and compare its diagnostic accuracy with the standard direct immunobead test. Both assays were simultaneously performed on each of 102 semen specimens from men with male factor infertility. The rate of detection of sperm autoantibodies was 16.6% and 19.6% by the direct immunobead test and sperm mixed antiglobulin reaction, respectively. Compared to the direct immunobead test, sperm mixed antiglobulin reaction demonstrated a sensitivity and specificity of 100% and 96%, respectively. The positive predictive value was 85% and the negative predictive value was 100%, emphasizing its particularly useful role as a screening tool for office based detection of sperm autoantibodies in men who present for evaluation of fertility potential.