10-YEAR EXPERIENCE WITH ANTISPERMATOZOAL ACTIVITY IN OVULATORY CERVICAL-MUCUS AND LOCAL HYDROCORTISONE TREATMENT

PROBLEM: During 1987-1996, cervical mucus spermagglutinating antibodie s of secretory immunoglobulin A (sIgA) or IgG detected by the tray agg lutination test (TAT) and the indirect mixed antiglobulin reaction (MA R) test were found in 234 women aged 23-39 years with previously unexp lained infertility. METHOD OF STUDY: Hydrocortisone was applied to the ectocervix. RESULTS: Spermagglutinating antibodies of sIgA disappeare d totally in 102 patients (91 resulting in deliveries of healthy babie s, 3 in ectopic pregnancies, and 8 in spontaneous miscarriages). A dec rease of spermagglutinating antibodies in ovulatory mucus during hydro cortisone application without pregnancy was registered in 60 infertile women. This group was referred to treatment by in vitro fertilization . No hydrocortisone effect on immunocompetent cells producing antisper matozoal IgG alone or combined with sIgA was seen in 72 patients. CONC LUSIONS: Vaginal mycosis, a side effect of hydrocortisone treatment, w as seen in seven cases. Hydrocortisone for local immunosuppression bec omes a valuable method of therapy in cervical immunologic infertility caused predominantly by antispermatozoal sIgA.