PROBLEM: The influence of anti-sperm (ASA), anti-phospholipid (APA), and an
ti-zonal (AZA) antibodies on in vitro fertilization (IVF) results and the n
eed for intracytoplasmic sperm injection (ICSI) were assessed.
METHOD OF STUDY: Forty-four couples with infertility of immunologic origin
were investigated. ASA in serum and ovulatory mucus were studied by a tray
agglutination test (TAT) and indirect mixed anti-globulin reaction test (MA
R) test, AZA were studied by passive hemagglutination and commercial enzyme
-linked immunosorbent assay (ELISA; BioGen, Germany), and APA were tested b
y ELISAs in immunoglobulin isotypes IgG and IgM.
RESULTS: Because of failed or very low fertilization after standard NF in t
he previous cycle. ICSI had to be used in five out of 15 cases with ASA (33
.3%), in 16 out of Is couples with AZA (89.4%), and in only one case if APA
were present (9%). Clinical pregnancy rate was 60% in cases with ASA, 38.5
% with AZA, and 27.3% per embryo transfer (ET) if APA were detected.
CONCLUSIONS: Immunologic infertility can be treated by IVF with very good r
esults. The most important group are women with AZA, in whom IVF-ICSI witho
ut any delay is recommended.