Am. Mahmoud et al., CLINICAL AND BIOLOGICAL ASPECTS OF MALE IMMUNE INFERTILITY - A CASE-CONTROLLED STUDY OF 86 CASES, Andrologia, 28(4), 1996, pp. 191-196
A case-control study of clinical, endocrine and seminal characteristic
s in 86 infertile men and a prospective study of conception rates duri
ng 804 follow-up cycles among 75 infertile couples with male immune in
fertility were performed. Genito-urethral infections or surgery, and p
alpable epididymal abnormalities were more common among the immunologi
cal cases than among the non-immunological infertile controls (n=180),
but sperm concentration, motility and morphology were similar. The sp
ontaneous conception rate in 70 cases was 1.7% per cycle. Treatment by
intra-uterine insemination (IUI) resulted in 8.6% pregnancies per cyc
le, conventional in vitro fertilization (IVF) had a 18.4% success rate
per attempt, and two out of three couples treated by intracytoplasmic
sperm injection (ICSI) attained pregnancy. Minimal sperm quality requ
ired for successful IUI was not lower than that recorded in couples wi
th spontaneous conception.It is concluded that immunological infertili
ty, as diagnosed by a positive mixed antiglobulin reaction (MAR) test,
is associated with a low spontaneous conception rate. Techniques of a
ssisted reproduction are useful in the management of couples with infe
rtility resulting from this pathology, but sperm characteristics requi
red for successful IUI are much higher than those needed for successfu
l IVF. A strategy for the logical management of this pathology is prop
osed.