Evaluation of the immunological cause of male infertility

Summary. The presence of antisperm antibodies was considered as one of the main causes of maleinfertility. This study was conducted on 776 semen samples of the male partners of infertile couples in order to evaluate the immunological factor. The detection of antisperm antibodies was performed by means of the direct Mixed Antiglobulin Reaction (MAR) test. A positive test was found in 35 samples. Hence, the prevalence of immunological infertility in this study is 4.5% among the male partners of infertile couples. Further explorations were performed on men with positive results, in order to detect the presence of antibodies in the sera by means of the indirect MAR tests, and sperm immobilization tests for quantitating the cytotoxic activity of the antibodies. The indirect MAR tests showed that 97% of the antibodies were present in sera, whereas 51% of the samples were cytotoxic. Routine semen analysis indicated that around 60% of the semen samples with antisperm antibodies were good. Semen culture showed that positive results were detected in 40% of samples. Clinical evaluations revealed that the presence of antisperm antibodies may have been the cause of long-standing infertility, on average 5 years, and were not all primary. Evaluations of all clinical and laboratory findings indicated that unilateral testis obstruction and male accessory gland infection were the main pathologies found.