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Male immunologic infertility: sperm performance on in vitro fertilization
M H Vazquez-Levin1, J A Notrica, E Polak de Fried
1Centro de Salud Reproductiva CER, Buenos Aires, Argentina. VAZQUEZ@IBYME.EDU.AR
Objective:
To analyze sperm performance in a group of patients with male immunologic infertility treated with IVF-ET.
Design:
Retrospective clinical study.
Setting:
Patients attending a private IVF clinic.
Patient(S):
The study group comprised seven men with significant levels of surface-bound antisperm antibodies treated in nine IVF cycles. The control group comprised nine couples with female tubal infertility and no indication of male factor infertility treated on the same cycle.
Intervention(S):
None.
Main Outcome Measure(S):
Fertilization rate, early embryonic development, implantation, and clinical pregnancy rate (PR).
Result(S):
Forty-six (44.2%) of 104 inseminated oocytes were fertilized in the study group compared with 65 (84.4%) of 77 in the control group, which was a significant difference. Surface-bound antisperm antibodies significantly inhibited early embryonic cleavage in the study group (13 [28.3%] of 46 embryos with at least 3 blastomeres) compared with the control group (41 [63.1%] of 65 embryos, with at least 3 blastomeres). The percentage of good-quality embryos (grades 1 and 2) was similar in the study and control groups (71.7% and 78.5%, respectively). The percentage of poor-quality embryos (grade 4 and two pronuclei) was higher in the study group compared with the control group (13.9% versus 9.2%, respectively); however, the difference was not significant. The implantation rate and clinical PR were lower in the study group (3% and 11%, respectively) compared with the control group (9.5% and 44%, respectively), but the difference was not statistically significant.
Conclusion(S):
The fertilization rate and early embryonic cleavage of human embryos was found to be reduced significantly in patients with high levels of surface-bound antisperm antibodies. Moreover, embryonic quality and the PR may be compromised by the presence of significant levels of surface-bound antisperm antibodies.