G. Knudson et al., PREVALENCE OF SPERM BOUND ANTIBODIES IN INFERTILE MEN WITH VARICOCELE- THE EFFECT OF VARICOCELE LIGATION ON ANTIBODY-LEVELS AND SEMEN RESPONSE, The Journal of urology, 151(5), 1994, pp. 1260-1262
An increased level of antisperm antibodies has been demonstrated in in
fertile men with varicocele compared with normal fertile men, suggesti
ng a possible cause and effect relationship. To evaluate the possible
etiological role of antisperm antibodies in varicocele patients, we pe
rformed a prospective study of 32 infertile men undergoing varicocele
ligation. Semen analyses and antisperm antibodies as measured by the i
mmunobead test were performed preoperatively and postoperatively at 3
and 6 months. Of the infertile men with varicocele 28% had a positive
immunobead test compared with 0% of normal fertile men. The average to
tal motile sperm count was significantly different (p <0.05, 2-tailed
t test) for 9 varicocele patients with sperm-bound antibody (3.2 x 10(
6)) compared with 23 without antibody (8.4 x 10(6)). Postoperatively,
68% of all patients exhibited improved semen parameters, with no chang
e in antibody status in either group. Among the antibody positive grou
p 71% showed an increase in motile sperm per mi. of 2.8 x 10(6) to 17.
2 x 10(6) (525% increase, p <0.05), while in the antibody negative gro
up 67% showed an increase of 3.8 x 10(6) to 24.9 x 10(6) (553% increas
e, p <0.05). Our study suggests that there is an increased incidence o
f sperm-bound immunoglobulin in infertile varicocele patients and an a
pparent adverse effect on semen parameters in these patients. However,
the presence of sperm-bound immunoglobulin did not affect the percent
age response to surgical correction, nor can we postulate an immunolog
ical mechanism as a major etiological factor in varicocele induced inf
ertility.