A. Lahteenmaki et al., LOW-DOSE PREDNISOLONE DOES NOT IMPROVE THE OUTCOME OF IN-VITRO FERTILIZATION IN MALE IMMUNOLOGICAL INFERTILITY, Human reproduction, 10(12), 1995, pp. 3124-3129
Early reports of male immunological infertility suggested a decline in
antisperm antibody concentrations in some patients after even short-t
erm (10 day) therapy with low-dose prednisolone. In the present study,
53 men with positive results in spermatozoal mixed antiglobulin react
ion (MAR) and serum tray agglutination tests (TAT), were randomized to
receive either 20 mg of prednisolone or placebo daily for 2 weeks pri
or to in-vitro fertilization (IVF) treatment. The antibody levels were
also monitored by flow cytometry (FCM), There were no significant dif
ferences between these groups as regards fertilization rates (35% with
prednisolone; 39% with placebo) and pregnancy rates (29%; 32%), No si
gnificant changes occurred in either MAR or FCM results in relation to
therapy, Patients with fertilization rates of <10% had significantly
higher immunoglobulin G (IgG) MAR values compared with those with bett
er fertilization, whereas there was no relationship between IgA levels
and fertilization results, As regards FCM, the results were similar,
but without statistical significance. In conclusion, IVF is a good cou
rse of action in severe male immune infertility, but low-dose predniso
lone therapy does not lower the sperm-bound antibody numbers and does
not improve the IVF outcome.