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  • Title: The investigation of immunological infertility.
    Author: Jones WR.
    Journal: Med J Aust; 1979 Aug 25; 2(4):188-92. PubMed ID: 390335.
    Abstract:
    Immune reactions to spermatozoa may interfere with fertility in both males and females. These mechanisms may operate in a small, but significant, proportion of infertile couples, particularly when the duration of infertility is greater than three years. Antibodies to sperm may appear both in the blood and in genital tract secretions and their presence should be sought in both sites. The most suitable screening test for circulating anti-sperm antibodies in either partner is a method based on the complement-dependent antibody immobilization of sperm. This test may also be applied to cervical mucus as a routine in females. In males the detection of sperm immobilizing antibodies in blood serves as a reasonable guide to the existence of antibodies in seminal plasma where their presence may be confirmed using a gelatin agglutination test. Further information about the presence of locally secreted antibodies either in cervical mucus or in semen may be gained by using the sperm-cervical mucus contact (SCMC) test in which cross-testing with donor mucus or sperm will identify the site of local antibody production. Results based on immunofluorescence and sperm microagglutination methods are unreliable and lacking in correlation with continuing infertility and the routine use of these tests is not recommended. An immune reaction to spermatozoa which interferes with fertility may operate in a small, but significant, proportion of couples. The immune reaction is more likely to be operating when the duration of infertility is greater than 3 years. Sperm antibodies may appear in the blood and in genital tract secretions. They should be sought in both locations. A method based on the complement-dependent antibody immobilization of sperm is the most suitable method for screening antisperm antibodies in either partner. In females the test may be routinely applied to the cervical mucus. Sperm antibodies in the male's blood is a reasonable indicator of antibodies in the seminal plasma where they may be confirmed by a gelatin agglutination test. The sperm-cervical mucus contact test (SCMC), in which cross-testing with donor mucus or sperm will identify the site of local antibody production, will provide further information about the presence of locally secreted antibodies. Immunofluorescence and sperm microagglutination methods are unreliable and lacking in correlation with continuing infertility and the use of these tests is not recommended.
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