MULTIVARIANT ANALYSIS OF MEN FROM INFERTILE COUPLES WITH AND WITHOUT ANTISPERM ANTIBODIES

PROBLEM: Research studies in animal and human systems have demonstrate d conclusively that antisperm antibodies can interfere with fertilizat ion. In the male, autoantibodies to sperm can be detected both in the sera and seminal plasma.METHOD OF STUDY: Ninety-seven men who were tes ted for antisperm antibodies as a part of an infertility evaluation we re identified. Complete medical history was obtained, including inform ation related to events suspected of being associated with antisperm a ntibodies. History of surgery (varicocele repair, hernia repair, and v as reversal) and infection (epididymitis, sexually transmitted disease , and orchitis) were compared with semen parameters (motility less tha n 60%, concentration less than 20 x 10(6), and volume less than 2 cc). These were compared to antisperm antibody results of mixed agglutinat ion reaction (MAR) and direct immunobead binding test (IBT) for immuno globulin G (IgG). Statistical analysis was performed using Fishers exa ct two-tailed test. RESULTS: As expected, prior vas reversal was signi ficantly associated with the presence of antisperm. antibodies (P = 0. 0002) by MAR or IBT with a fivefold increased relative risk (95% confi dence interval, 1.97-12.38). Other surgeries manipulating the cord str uctures independent of vas reversal were not associated with antisperm antibodies (P = 0.09). Prior infections, independent of vas reversal, were significantly associated with antisperm antibodies by MAR (P = 0 .04) with a 3.8-fold increased relative risk (95% confidence interval, 1.06-13.87) but not by IBT. Sperm concentration less than 20 x 10(6), motility less than 60%, and a volume less than 2 cc were not associat ed with antisperm antibodies by MAR or IBT. CONCLUSION: These findings suggest that manipulation of the cord structures excluding the vas we re not associated with antisperm antibodies; however, vas reversal and prior infection are significant risk factors for the development of a ntisperm antibodies.