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A new microassay for spermocytotoxic antibody: comparison with passive hemagglutination assay for antisperm antibodies in couples with unexplained fertility.
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1981
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Abstract A rapid, specific, and sensitive assay has been established for measurement of cytotoxic antisperm antibody titers by a double staining method. This assay was used in a study of 25 normal fertile couples and 148 couples with unexplained infertility. Serum titers of cytotoxic antisperm antibody for the 25 fertile males (group A) averaged 8 ± 1 (mean ± SEM). Of the males from infertile couples, 86 (group B) had no apparent antisperm immunity (mean titer 11 ± 1), and 62 (group C) showed “autoimmunity” to sperm in this assay (mean titer 127 ± 18; p < 0.001). Cytotoxic antibody titers in seminal plasma samples from group C (263 ± 45) were also higher (p < 0.001) than for group A (10 ± 12) or B (40 ± 18). For the 25 fertile females (group D), serum titers in this assay averaged 3 ± 1; 83 females from infertile couples (group E) showed no immunity to sperm (8 ± 1), and 65 (group F) showed “isoimmunity” to sperm (134 ± 19; p < 0.001). Titers in the cervical and vaginal secretions were higher for group F than group D or E and higher for group E than for group D. The results of this assay corresponded well with those of our previously established passive hemagglutination method. Results obtained by these 2 methods indicated a) that agglutinating antibodies appear earlier in the systemic circulation than do cytotoxic antibodies, b) that cytotoxic antibodies present in the seminal plasma of males and in the cervical and vaginal secretions of females are responsible for sperm killing locally in the reproductive tract, possibly mediated by a secretory immune system distinct from the systemic humoral immune system, and c) that female isoimmunity is associated with male autoimmunity, in that 89% of the husbands of infertile women with isoimmunity to sperm were “autoimmune” as compared with 5% of the husbands of infertile women with normal levels of antisperm antibodies.