ANTISPERM ANTIBODIES IN CRYPTORCHIDISM BEFORE AND AFTER SURGERY

Purpose: We verified the prevalence of serum antisperm antibodies at d iagnosis in a large group of cryptorchid boys, and determined whether it may be influenced by orchiopexy. Materials and Methods: We prospect ively evaluated serum antisperm antibodies in 186 and 23 boys 0.67 to 14.25 years old with unilateral and bilateral cryptorchidism, respecti vely, before, and 3, 12 and 24 months after surgery. At diagnosis Tann er stage was 1 and 2 or 3 in 188 and 21 cases, respectively. During th e 2-year followup 23 boys entered puberty. A total of 111 normal prepu bertal (Tanner stage 1) and 54 pubertal (Tanner stage 2 or 3) boys ser ved as controls. Antisperm antibodies were detected using the tray agg lutination and indirect immunobead tests. Results: At diagnosis 29 cry ptorchid boys (13.8%) were antisperm antibody positive, including 21 o f the 188 prepubertal (11.1%) and 8 of the 21 pubertal (38%) boys (sig nificantly different, chi-square test p <0.001). In 27 cases the tray agglutination test was positive with titers between 1:16 and 1:512, in 18 the indirect immunobead test was positive for IgG with titers betw een 1:10 and 1:100, and in 16 both tests were positive. There was no s tatistical difference when antisperm antibody results were analyzed fo r unilateral and bilateral cryptorchidism or testis location. All norm al boys were antisperm antibody negative. During the 2-year followup a ntisperm antibodies appeared in 1 previously negative case, and the an tibody titer increased to 128 to 512 in the tray agglutination and to 1:100 in the indirect immunobead tests in 4 positive cases. In all of these cases pubertal changes were also observed. Conclusions: Our stud y indicates that cryptorchidism may elicit an autoimmune response agai nst sperm antigen in childhood independent of testis location and orch iopexy. Moreover, patients of pubertal age appear to be at higher risk for antisperm antibody development.