Risk Factors for Antisperm Antibodies in Infertile Men

TLDR

Anti‑sperm antibodies are present in 7–26 % of infertile men, yet their role in male infertility remains controversial despite known risk factors such as varicocele, cryptorchidism, vasectomy, and genital infections. The study aimed to determine whether a single clinical parameter could identify infertile men with elevated ASA titers by testing 226 consecutive patients with an ELISA. A novel synchron ELISA that omits sperm surface antigen fixation with formaldehyde or glutaraldehyde was used, providing a highly sensitive and reproducible quantitative assay. ASAs were detected in 14 % of the cohort versus 2.5 % in controls, and only vasectomy history, acute epididymitis, and abnormal bovine mucus penetration test results were significantly associated, with ASA levels increasing over time after vasectomy.

Abstract

PROBLEM: The prevalence of anti‐sperm antibodies (ASAs) in the general population is 0 to 2%; the prevalence in infertile men is much higher at 7 to 26%. However, the role of ASAs in male infertility remains controversial to date. Although several risk factors for ASA development have been defined (such as testicular torsion, varicocele, cryptorchidism, vasectomy, and genital tract infection), there are no specific indications for ASA testing. METHOD: In order to examine if a single parameter exists identifying patients with elevated ASA titers, serum ASA testing was performed with an enzyme‐linked immunosorbent assay (ELISA) in 226 consecutive male patients. The new assay, synchron ELISA (Syn elisa ) used in our study represents a new type of ELISA without fixation of the sperm surface antigens by formaldehyde or glutaraldehyde. Therefore the quantitative assay is highly sensitive and reproducible since the structure of sperm surface antigens is not altered by the fixation process. RESULTS: The prevalence of ASAs in this population was 14%, while the prevalence of the control group was 2.5%. Of all factors analyzed only a history of vasectomy, an acute epididymitis, and an abnormal result in the bovine mucus penetration test was associated with elevated ASA titers ( P <001). In addition, we could demonstrate a time related formation of ASAs in men after vasectomy. CONCLUSIONS: