VALIDITY AND COST-EFFECTIVENESS OF ANTISPERM ANTIBODY TESTING BEFORE IN-VITRO FERTILIZATION

Objective: To determine the usefulness of and cost-effectiveness of an tisperm antibody testing in the prediction of poor fertilization rates in couples undergoing NF. Design: Retrospective cohort study. Setting : A hospital-based reproductive endocrinology and infertility practice .Patient(s): Male partners of 251 couples undergoing IVF between 1992 and 1997.Main Outcome Measure(s): Fertilization rates in couples under going conventional NF. Result(s): One hundred nineteen couples were ev aluated for antisperm antibodies; fertilization rates were similar in those couples whose husbands were and were not tested (64% versus 68%) . Antisperm antibodies were detected in 16 men. Four (25%) of the 16 c ouples whose husbands had antisperm antibodies fertilized less than or equal to 50% of oocytes, compared with 31 (30%) of the 103 couples wh ose husbands did not have these antibodies. Overall, 21 couples (8.4%) experienced complete fertilization failure, in a program that include d antisperm antibody testing for selected couples and intracytoplasmic sperm injection (ICSI) for those who tested positive, it would cost $ 11,735 to prevent a fertilization failure (assuming ICSI were 100% eff ective), whereas it would cost $9,250 to perform ICSI in a second IVF cycle for those who initially failed. Conclusion(s): Ln this practice setting, antisperm antibody testing has low sensitivity in predicting low or no fertilization and does not appear to be cost-effective when selectively ordered as part of an IVF workup. (C) 1998 by American Soc iety fur Reproductive Medicine.