Sperm-agglutinating antibodies in 236 infertile couples

19 wives of 236 couples had positive sperm agglutination tests. (SPAT) 6 of the 19 belonged to the 70 couples (9.4%) with no no known cause for infertility; 11 belonged to the group of 154 couples (7.1%) with a known cause; and 2 to the 12 couples inadequately investigated (15.7%). 6 of these 19 women (31.6%) became pregnant without condon therapy; of these 6, 3 had no known cause for infertility and 3 had a known cause. 11 husbands had positive sperm aggluatination tests. 4 of these 11 were among the 70 couples (5.6%) with no known cause for infertility, while the other 7 were among the 154 couples (4.5%) with a known cause. 5 of their wives (45.5%) became pregnant without any treatment. Outcomes of 8 of 11 pregnancies were normal deliveries and no abortioons, which showed that positive SPAT had no apparent effect on the pregnancies. There was no relationship between postitive SPAT and history of venereal disease, allergy, autoimmune disease, abortioon, postcoital tests, or ABO imcompatability.     

Sperm-agglutinating antibodies and decreased fertility in prostitutes

Forty-eight prostitutes were studied for the presence of sperm-agglutinating antibodies. Thirty-five, or 72.7%, were positive. A control group of 25 unmarried women had a 20% incidence of reactions. The specificity of the microagglutination test is discussed. No false positive reactions have occurred from pH, dilution effects, or washing technics used in our procedure. The test reaction is related to seminal plasma-coating antigen. Prostitutes have a poor reproductive history and a high incidence of abortion. Our data suggest a relationship between circulating antibody titers and decreased fertility, but no relationship to increased abortion rate. Tissue-fixed antibodies are demonstrated in cervical and endometrial tissue of 5 prostitutes with circulating antibody titer. The significance of this finding is discussed.     

ELISA for antisperm antibodies in unexplained infertile women

It is commonly believed that autoimmune or isoimmune responses to human sperm antigens are associated with human infertility. We examined an enzyme linked immunosorbent assay (ELISA) kit used in the detection of antisperm antibodies in the sera of women with unexplained infertility. 1) For the ELISA assay, an absorbance at 405nm greater than 0.300 was considered positive. Of the 83 sera of infertile women studied, 20(24.1%) were positive. This value was significantly higher than that of the control group: 10% of pregnant women, 11.1% of unmarried women and 10% of healthy men (p less than 0.05). 2) The results obtained with ELISA were compared with those of the sperm immobilization test. Comparison of the results of ELISA with those of the sperm immobilization test indicated that these methods detect a different, though often overlapping, spectrum of antibody activity. 3) The results obtained with ELISA did not always correlate with those of the Huhner test. However the ELISA method may be useful in the clinical screening of antisperm antibodies because of its simplicity and rapidity.     

Local hydrocortisone treatment of sperm-agglutinating antibodies in infertile women

Local sperm-agglutinating antibodies (LSAA) in the cervical ovulatory mucus may be a cause of primary infertility. A group of 17 infertile women with LSAA treated without effect with artificial insemination and then condom therapy were studied. After hydrocortisone application to the ectocervix for up to four cycles, LSAA disappeared totally in 13 patients; six of them have given birth to babies. No side effects of treatment were observed. Hydrocortisone for local immunosuppression may become a new method of therapy in cervical immunological infertility.     

Spermagglutinating antibodies and beta-spermagglutinins in sera from infertile and fertile women

Sera from five groups of women were investigated by the tray agglutination technique for the presence of spermagglutinins: (1) 326 women from infertile couples, (2) 51 women in early pregnancy, (3) 65 women in advanced pregnancy, (4) 41 oral contraceptive users, and (5) 109 presumably fertile, nonpregnant women. By absorbing spermagglutinating sera with a cell-free eluate from spermatozoa, agglutination disappeared when due to a high-molecular weight compound with beta-mobility in preparative zone electrophoresis (denoted beta-spermagglutinin), whereas activity due to sperm antibodies was unchanged. Spermagglutinating sera occurred with comparable frequency among women from infertile couples, women in advanced pregnancy, and oral contraceptive users. The absorption study revealed agglutinating antibodies in a significantly higher frequency and in higher titers among women of infertile couples than among fertile women, in whom beta-spermagglutinins were found almost exclusively. These results demonstrate the importance of discriminating between sperm antibodies and beta-spermagglutinins in studies of sperm antibodies as a cause of infertility in women.     

Specific IgG and IgA antibodies to Chlamydia trachomatis in infertile women

IgG, IgA, and IgM antibody titers to Chlamydia trachomatis were determined in sera of 80 infertile women and 100 controls by a single antigen (L-2) immunoperoxidase assay. The infertile women included 50 with unexplained infertility and normal hysterosalpingogram (HSG) and 30 with abnormal HSG. The control sera included 50 from primiparous and 50 from multiparous women. The prevalence of C. trachomatis IgG antibody was significantly higher in infertile women with abnormal HSG as compared with infertile patients with normal HSG and controls (87% v. 20% and 10%, respectively). The geometric mean titer (GMT) of C. trachomatis IgG antibodies of infertile women with abnormal HSG was significantly higher than those of controls (20.7 v. 5.6). A significantly higher prevalence of C. trachomatis IgA antibodies was found in infertile women with both abnormal and normal HSG than in controls (77% and 14% v. 3% respectively). No C. trachomatis IgM antibodies (less than 2) were found in any of the infertile or control groups. The possibility that serum C. trachomatis IgA antibodies may serve as a marker for early recognition of persistent C. trachomatis is discussed.     

Alexithymia in infertile women

OBJECTIVE: Alexithymia was compared in women with fertility disorders and fertile women who have never been confronted with fertility problems. METHOD: Self-report instruments (TAS-20 and BVAQ) were used to measure alexithymia in a group of 73 infertile women and in a comparison group of 32 fertile women. Semi-structured interviews were used to assess medical history, current and lifetime diagnosis of psychiatric disorders. RESULTS: Infertile women showed significantly higher rates of alexithymia than fertile women. The degree of alexithymia does not constitute a discriminating variable between unexplained infertile women and women with an organic aetiology of infertility. The prevalence of psychiatric diagnosis did not differ between the two groups of patients. Lifetime prevalence of depression, obsessive-compulsive disorders, post-traumatic stress disorder were statistically comparable. CONCLUSION: This result raises the question of secondary alexithymia as a coping strategy in women with fertility troubles. Given the lack of published data on alexithymia in infertile women, there is a need to replicate our results and evaluate other aspects of affect regulation in infertile patients.     

Diagnosis and treatment of immunologically infertile women with sperm-immobilizing antibodies in their sera

Detection of sperm-immobilizing antibodies in women may have relevance for diagnosis of immunological infertility. Infertile women in whom sperm-immobilizing antibodies are detected can be refractory to conventional treatments such as timed intercourse or intrauterine insemination (IUI) because the antibodies secreted in the female reproductive tract might impair sperm passage, inhibit fertilization, and prevent normal post-fertilization processes. Hence, manipulation of gametes and embryos from patients with sperm-immobilizing antibodies should be carried out with additional care to avoid fertilization failure resulting from the presence of antibodies during in vitro fertilization (IVF). Moreover, the reasons for the why majority of women do not develop sperm-immobilizing antibodies on exposure to sperm is not clear. The production of sperm-immobilizing antibodies is likely to occur in women with particular HLA haplotypes after repeated exposure to sperm. Characterization of sperm-immobilizing antibodies may help in the identification and characterization of sperm specific antigens that can be used as candidate antigens for the development of sperm based contraceptive vaccines.     

Sperm antibodies in the cervical mucus and sera and postcoital tests in infertile women

Cervical mucus and sera of 42 women with infertility resistant to treatment were investigated for spermatozoal antibodies by agglutination, immobilization and immunofluorescent tests. Quantitative postcoital tests were also performed. The incidences of sperm antibody activity in cervical mucus varied from 48 to 62%. There seemed to be no relationship between antibodies in the sera and cervical mucus. In the presence of adequate cervical mucus, the postcoital test could be correlated with sperm antibodies in the cervical mucus as tested by the Isojima's immobilization test (P < 0.05). No relationship was seen between the postcoital tests and sperm antibodies in the mucus by the other 2 tests and between the postcoital tests and sperm antibody activity in the sera by all 3 tests.     

Recovery of Chlamydia trachomatis from the endometrium in infertile women with serum antichlamydial antibodies

Upper genital tract infection with Chlamydia trachomatis appears to be a frequent cause of salpingitis and tubal infertility. However, the prevalence of active infection in women with infertility has not been well-defined. To examine this question, endocervical and endometrial cultures for C. trachomatis were obtained from infertile women with serum antibodies to C. trachomatis. The first 19 consecutive patients with titers greater than or equal to 1/32 were cultured. C. trachomatis was recovered from the endometrium or endocervix in six (32%) of the women examined and from the endometrium in five (26%). These findings indicate that a significant portion of infertile women with serum antichlamydial antibodies may have active upper genital tract infection with C. trachomatis at the time of presentation.     

Recognition of carbohydrate antigen epitopes by sperm-immobilizing antibodies in sera of infertile women.

STUDY OBJECTIVE: To study carbohydrate natures in the antigen epitopes corresponding to sperm-immobilizing antibodies in infertile women. DESIGN: Antibody absorption with human sperm and seminal plasma before and after treatments with trifluoromethanesulfonic acid or sodium metaperiodate. PATIENTS: Thirty-three patients who showed a positive sperm immobilization test provided their sera for the experiment. RESULTS: In 25 patients' sera whose sperm-immobilizing antibodies were absorbed with human seminal plasma, the antibody absorbing capabilities were completely abolished by deglycosylation treatment with trifluoromethanesulfonic acid. The sperm-immobilizing antibodies in 4 patients' sera were absorbed out with sperm membrane fraction before the treatment but not after the treatment with trifluoromethanesulfonic acid. In some patients' sera, the antibody-absorbing capabilities of ejaculated sperm were markedly reduced by sodium metaperiodate treatment. CONCLUSION: The majority of sperm-immobilizing antibodies in infertile patients might be generated to carbohydrate structures of the sperm-coating antigens or sperm membrane antigens.     

Sperm immobilizing antibodies in the serum and cervicovaginal secretions of infertile and normal women

A search was made for sperm immobilizing antibodies in the sera and in the cervicovaginal secretions of 39 women in whom apparent cervical mucus hostility was the only explanation for infertility. Anti-sperm antibodies were found in 25.6 per cent of sera and 20.5 per cent of cervicovaginal secretions. No such antibodies were detected in controls.