[Male infertility of immunologic origin and its treatment]

Antibodies against sperm surface antigens may be responsible for 3 to 20% of idiopathic male infertility cases. Antisperm immunisation may be suspected in view of a clinical suggestive history, a spontaneous sperm-agglutination and an inability of spermatozoa to penetrate a normal cervical mucus. The responsibility of antisperm antibodies in the infertility state could be demonstrated in vitro by their effects on several sperm functions. An inverse correlation between antibodies titres and conception rates has been demonstrated and it justifies a therapeutical approach in the presence of high levels of antibodies. Corticosteroids must not be used as the results obtained did not justify the side effects observed. Intra-uterine insemination as well as in vitro fecundation can help some of these couples but results must be improved by better methods of selection of motile sperm populations devoid of antibodies.