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Evaluation of the immunological cause of male infertility
A Hinting1, D M Soebadi, R I Santoso
1Department of Biomedicine, Faculty of Medicine, Airlangga University, Surabaya, Indonesia.
Abstract:
The presence of antisperm antibodies was considered as one of the main causes of male infertility. This study was conducted on 776 semen samples of the male partners of infertile couples in order to evaluate the immunological factor. The detection of antisperm antibodies was performed by means of the direct Mixed Antiglobulin Reaction (MAR) test. A positive test was found in 35 samples. Hence, the prevalence of immunological infertility in this study is 4.5% among the male partners of infertile couples. Further explorations were performed on men with positive results, in order to detect the presence of antibodies in the sera by means of the indirect MAR tests, and sperm immobilization tests for quantitating the cytotoxic activity of the antibodies. The indirect MAR tests showed that 97% of the antibodies were present in sera, whereas 51% of the samples were cytotoxic. Routine semen analysis indicated that around 60% of the semen samples with antisperm antibodies were good. Semen culture showed that positive results were detected in 40% of samples. Clinical evaluations revealed that the presence of antisperm antibodies may have been the cause of long-standing infertility, on average 5 years, and were not all primary. Evaluations of all clinical and laboratory findings indicated that unilateral testis obstruction and male accessory gland infection were the main pathologies found.
Insights
Prevalence of antisperm antibodies in infertile men is 4.5%. These antibodies, often found in serum and sometimes cytotoxic, contribute to long-standing male infertility, with obstruction and infection being common causes.
Area of Science:
- Reproductive Immunology
- Andrology
- Urology
Background:
- Antisperm antibodies are a significant factor in male infertility.
- Immunological causes require thorough evaluation in infertile couples.
Purpose of the Study:
- To determine the prevalence of antisperm antibodies in male partners of infertile couples.
- To characterize the immunological and clinical factors associated with antisperm antibodies.
Main Methods:
- Direct Mixed Antiglobulin Reaction (MAR) test on 776 semen samples.
- Indirect MAR tests and sperm immobilization tests on positive samples.
- Routine semen analysis, semen culture, and clinical evaluations.
Main Results:
- A 4.5% prevalence of antisperm antibodies was detected using the direct MAR test.
- Indirect MAR tests confirmed antibodies in 97% of sera; 51% showed cytotoxic activity.
- Semen analysis was normal in 60% of positive cases; 40% had positive semen cultures. Unilateral testis obstruction and male accessory gland infection were primary pathologies.
Conclusions:
- Antisperm antibodies contribute to male infertility, often long-standing.
- Immunological factors, alongside obstruction and infection, are key in male infertility evaluations.
- Further investigation into immunological markers is crucial for diagnosing male infertility.