Absence of antisperm surface antibodies in prepubertal boys with cryptorchidism and other anomalies of the inguinoscrotal region before and after surgery

Purpose: Although the prepubertal immune system cannot recognize postmeioti c germ cell antigens, an overall 21 to 28% incidence of antisperm antibodie s directed at these antigens has been reported preoperatively in prepuberta l children with cryptorchidism and other inguinoscrotal anomalies. We inves tigated the prevalence of antisperm antibodies in these prepubertal patient s before and after surgery. Materials and Methods: We examined 82 prepubertal boys 0.6 to 13.2 years ol d, including 33 with unilateral cryptorchidism, 21 with inguinoscrotal anom alies and 28 who were normal. IgG, IgM and IgA antisperm antibodies were de termined by the indirect Immunobead* test. Serum testing was repeated 1 and 2 years postoperatively and annually for 2 more years in the normal childr en. Also sera from 183 infertile men 21 to 47 years old with a history of c ryptorchidism and/or inguinal hernia operated on in childhood were similarl y studied. Results: Of the adults 70 (39%) tested IgG positive, including 12 (7%) who were also IgA positive, and all tested IgM negative. Repeat measurements we re negative for all IgG, IgA and IgM isotypes in all children, patients and controls. Conclusions: We conclude that there are no antibodies to sperm surface anti gens in prepubertal children with cryptorchidism and inguinoscrotal anomali es before and within 2 years after surgery. Autoimmunity against postmeioti c sperm membrane antigens is apparent in adults only.