OFFICE-BASED SCREENING OF SPERM AUTOIMMUNITY

Sperm autoimmunity has been reported as a contributory cause of male f actor infertility in up to 10% of subfertile men. The standard laborat ory technique for the determination of sperm bound antisperm antibodie s is the direct immunobead test. However, because of its complex metho dology this test does not readily lend itself as a screening tool for this diagnosis. We describe a simple office based procedure, the sperm mixed antiglobulin reaction, for the detection of antisperm antibodie s and compare its diagnostic accuracy with the standard direct immunob ead test. Both assays were simultaneously performed on each of 102 sem en specimens from men with male factor infertility. The rate of detect ion of sperm autoantibodies was 16.6% and 19.6% by the direct immunobe ad test and sperm mixed antiglobulin reaction, respectively. Compared to the direct immunobead test, sperm mixed antiglobulin reaction demon strated a sensitivity and specificity of 100% and 96%, respectively. T he positive predictive value was 85% and the negative predictive value was 100%, emphasizing its particularly useful role as a screening too l for office based detection of sperm autoantibodies in men who presen t for evaluation of fertility potential.