MALE IMMUNOLOGICAL INFERTILITY - SPERM PERFORMANCE ON IN-VITRO FERTILIZATION

Objective: To analyze sperm performance in a group of patients with ma le immunologic infertility treated with IVF-ET. Design: Retrospective clinical study. Setting: Patients attending a private IVF clinic. Pati ent(s): The study group comprised seven men with significant levels of surface-bound antisperm antibodies treated in nine IVF cycles. The co ntrol group comprised nine couples with female tubal infertility and n o indication of male factor infertility treated on the same cycle. Int ervention(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 fertili zed in the study group compared with 65 (84.4%) of 77 in the control g roup, which was a significant difference. Surface-bound antisperm anti bodies significantly inhibited early embryonic cleavage in the study g roup (13 [28.3%] of 46 embryos with at least 3 blastomeres) compared w ith the control group (41 [63.1%] of 65 embryos, with at least 3 blast omeres). The percentage of good-quality embryos (grades 1 and 2) was s imilar in the study and control groups (71.7% and 78.5%, respectively) . The percentage of poor-quality embryos (grade 4 and two pronuclei) w as higher in the study group compared with the control group (13.9% ve rsus 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 o f human embryos was found to be reduced significantly in patients with high levels of surface-bound antisperm antibodies. Moreover, embryoni c quality and the PR may be compromised by the presence of significant levels of surface-bound antisperm antibodies. (C) 1997 by American So ciety for Reproductive Medicine.