Objective: Here we compared the results of a
prospective study systematically screening for antisperm antibodies in a cohort
of subfertile males to the results of a previous retrospective study in equally
subfertile patients where screening for antisperm antibodies was performed
solely if semen presented spontaneous agglutinates of sperm. Methods: The prospective
study was conducted on 317 semen analyses between 1 September 2014 and 9 December
2015 and the retrospective study investigated 2823 semen analyses performed
between 1 April 2004 and 31 March 2014. Sperm parameter analysis used exactly
the same techniques across patients in both studies. Screening for IgG and IgA
class antisperm antibodies was performed by using the direct (in-semen) MAR test with immunobeads. Results: Retrospectively,
76 (2.69%) of the 2823 patients in the cohort had a positive MAR test after
presenting semen showing sperm agglutination. Compared to this group, the
prospective study found a significantly higher number of patients presenting
antisperm antibodies (positive MAR test in 25 patients, i.e. 7.88%). Of these 25 patients, IgA and mixed (IgG and IgA)
class antisperm antibodies were significantly higher in the prospective group
than those in the retrospective group. Conclusion: Given how antisperm antibodies
can damagingly block or hamper different prefertilization and possibly
postfertilization events, screening for antisperm antibodies solely on the
basis of sperm agglutinates does not look adequate. This study advocates making
screening for autoimmunity to sperm a routine part of the basic workup for male
subfertility.
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