RESULTS OF 55 INTRACYTOPLASMIC SPERM INJECTION CYCLES IN THE TREATMENT OF MALE-IMMUNOLOGICAL INFERTILITY

Antisperm antibodies present in the semen can be a primary cause of in fertility. If the proportion of spermatozoa carrying antisperm antibod ies is very high, then usually a poor result ensues in standard in-vit ro fertilization, We therefore employed intracytoplasmic sperm injecti on (ICSI) in 55 cycles (37 patients) where the proportion of antisperm antibody-bound spermatozoa was 80% or higher, as determined by the mi xed antiglobulin reaction (MAR) test. The type and location of antispe rm antibodies were determined by the immunobead test in 30 of the 37 p atients. The mean normal fertilization rate was 75.7% in these 55 cycl es, which was significantly higher than the fertilization rate in anot her 1767 ICSI cycles (69.2%) performed over the same period and where MAR-negative semen (the level of antisperm antibodies was < 80%) was u sed for microinjection, Embryonic development was comparable, but a hi gher proportion of poor-quality embryos was obtained with MAR-positive than with MAR-negative semen samples. Out of the 55 patients, 53 had embryos replaced (96.4%) and a fetal sac was detected by ultrasonograp hy in 14 patients (26.4%), The data indicate that fertilization, embry o development and pregnancy rates after ICSI are not influenced signif icantly by the proportion of antisperm antibody-bound spermatozoa, nor by the dominant type of antibodies present, nor by the location of th e antisperm antibody on the spermatozoa. The conclusion of this study is that ICSI should be the primary choice for patients who have high n umbers of antisperm antibodies present in their semen.