Comparison of the SpermMar test with currently accepted procedures for detecting human sperm antibodies.
TL;DR: The SpermMar test proved easier to use and to assess than the Immunobead test and it is recommended for consideration as a screening procedure for sperm antibodies despite the fact that at this stage only IgG antibodies can be detected.
Abstract: To eliminate the possibility of immunological infertility in spontaneously infertile and re-anastomosed men, a screening test that can be applied directly to semen is desirable. The SpermMar test is one such possibility. In this study, indirect tests for sperm antibodies using the commercial SpermMar test have been applied to a panel of sera whose reactions in the tube slide agglutination test (TSAT), gelatin agglutination test (GAT) and sperm immobilization test (SIT) for sperm antibodies are well characterized. The results from the SpermMar tests are compared directly with those obtained from Immunobead tests carried out at the same time. Results from screening tests performed on 30 sera confirmed complete correspondence between the GAT, SpermMar and Immunobead tests. When sera were titrated, the Immunobead test proved slightly more sensitive than the GAT and the SpermMar test was slightly more sensitive than the Immunobead test. The SpermMar test proved easier to use and to assess than the Immunobead test and it is recommended for consideration as a screening procedure for sperm antibodies despite the fact that at this stage only IgG antibodies can be detected.
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TL;DR: In approaching couples with infertility, a high index of suspicion for antibodies is necessary to avoid misdiagnosis, and in the optimal situation, all semen analyses should be screened for sperm-bound antibodies, but if this is impractical, testing should be performed on high-risk individuals.
Abstract: Immunoinfertility is an important problem, involving a significant number of infertile couples. Although the presence of antibodies on sperm has better prognostic value than those in serum or seminal plasma, it may not be the sole authentic evidence of immunoinfertility. Infertility from antisperm antibodies is likely only when they bind to a relevant sperm antigen involved in a specific fertility function. The variance in functional deficits seen in immunologic infertility is most likely related to antibodies directed at different sperm antigens or different class, subclass, or isotypes. Antibodies to FA-1 seem to be of significant importance in human immunoinfertility. In approaching couples with infertility, a high index of suspicion for antibodies is necessary to avoid misdiagnosis. In the optimal situation, all semen analyses should be screened for sperm-bound antibodies, but if this is impractical, testing should be performed on high-risk individuals (Table I). In couples in which the man has sperm-bound antibodies, and in whom there is no identifiable female factor, treatment should be instituted. Most treatments for immunoinfertility have been disappointing because of poor results, adverse effects, or high cost. Corticosteroid therapy has shown some promise in published reports (mostly poorly designed studies), but increase in pregnancy rate is modest and adverse effects may be significant. In our opinion, informed consent should be documented prior to institution of corticosteroid therapy, and subjects should be closely monitored. Advanced reproductive technologies offer a higher safety profile, and, with increasing technology, higher pregnancy rates. We recommend progressing from "low-tech" procedures, such as IUI and reserving the higher level procedures, such as IVF and ICSI, for those couples in whom pregnancy does not occur. The highest level reproductive technologies give the best current prospects for pregnancy in patients with this difficult problem but also are invasive and costly. It is hoped that further work in the laboratory will give rise to newer, safer, and less expensive effective treatments in the very near future.
87 citations
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TL;DR: Varicocelectomy may reduce the ASAB level, and this reduction has a good effect on semen parameter quality, and the level of antisperm antibodies (ASAB) in the serum and semen of infertile men with varicocele is raised in some patients.
Abstract: Objective: To study the level of antisperm antibodies (ASAB) in the serum and semen of infertile men with varicocele before and 6 months after varicocelectomy Materials and Methods: We performed a prospective study of 81 infertile men undergoing microsurgical inguinal varicocelectomy Female factor was excluded Semen analysis and seminal and serum ASAB (direct and indirect IgG and IgA), as measured by SpermMar test, were performed before and after surgery at 6 months A control group consisting of idiopathic infertile patients was evaluated for ASAB Results: Eighty-one patients with a mean age of 287 years (23 to 42) completed our study Mean sperm count, motility, and abnormal forms were improved after surgery and were statistically significant for sperm density and morphology (P < 005) Before surgery, 21 patients (26%) had a low positivity for ASAB (10 to 40%) Six months after surgery, the ASAB titer was reduced in 15 (A group), increased in 3 (B group), and reduced in another 3 (C group) The C group also had an increase in other titers In the A group sperm count, motility and normal forms improved after surgery (P < 005) In the B group, motility was reduced after surgery In the C group, motility and normal forms were reduced after surgery Sixty patients were negative for ASAB before surgery Of these, 48 showed an increase in at least one of the ASAB types to some degree that had no significant effect on semen parameters In the control group, two patients (7%) were weakly positive for ASAB Conclusions: Varicocelectomy may reduce the ASAB level, and this reduction has a good effect on semen parameter quality Also, it may raise the ASAB level in some patients This positive conversion has no adverse effect on semen parameters
25 citations
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TL;DR: The purpose of a debate contribution is to stir up controversy and discussion and a recent paper has done exactly that but aside from several criticisms already highlighted it seems that the view-point of Helmerhorst et al. (1999) is biased among other things by the selection of references.
Abstract: The purpose of a debate contribution is to stir up controversy and discussion and a recent paper (Helmerhorst et al. 1999) has done exactly that. However aside from several criticisms already highlighted (Bronson 1999) it seems that the view-point of Helmerhorst et al. (1999) is biased among other things by the selection of references. Both Helmerhorst et al. (1999) and Bronson (1999) fail to mention to mixed agglutination reaction (MAR) test using latex beads instead of red blood cells (SpermMar test; Fertipro Beernem Belgium); (Jager et al. 1978; Vermeulen and Comhaire 1983). In contrast to the polyacrylamide beads used in the immunobead test (MacMillan and Baker 1987) the latex particles have a uniform diameter of 2 µm. In the SpermMar test for immunoglobulin (Ig)G the particles are coated with IgG and they do attach to the region of the spermatozoa where the antisperm antibodies are located. This attachment is obtained by adding strong and highly specific anti-IgG to the mixture of fresh untreated spermatozoa and latex beads (Rasanen et al. 1994). There are also SpermMar tests for IgA and IgM. (excerpt)
23 citations
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TL;DR: The MAR test and immunobead test have a statistical significant correlation and their results provide evidence that there is no association between inflammatory/infectious diseases of the male reproductive tract and the presence of ASA in semen.
Abstract: The association between chronic inflammatory/infectious diseases of the male reproductive tract and the presence of antisperm antibodies (ASA) in semen is still controversial. We compared the results of the mixed agglutinin reaction (MAR) test and immunobead test for detecting ASA type IgG and IgA in 133 patients attending our special outpatient department for andrological infections and evaluated the differences in the detection rate of ASA. Patients were divided into three groups: a study group that included 79 patients with symptomatic nonacute inflammatory/infectious diseases of the seminal tract, a control group (n = 44) and a third group of men with a history of successful vasectomy reversal (n = 10). The two tests correlated in a statistically significant manner for the detection of IgG and IgA in all groups. The overall positive detection rate of clinical significant levels of IgG and IgA was 2.5% and 1.3% (respectively) in the patients with inflammation/infection of the seminal tract. No statistical significant difference in the detection rate of ASA levels between the inflammatory/infectious group and the controls was detected. The results of the MAR test and immunobead test have a statistical significant correlation and their results provide evidence that there is no association between inflammatory/infectious diseases of the male reproductive tract and the presence of ASA in semen.
21 citations
Cites background from "Comparison of the SpermMar test wit..."
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TL;DR: To compare the sperm mixed‐agglutination reaction (sMAR) with the peroxidase‐labelled protein A method (POPA) in infertile patients with varicocele, the objective was to establish an experimental procedure and show direct comparison between the two methods.
Abstract: Objective
To compare the sperm mixed-agglutination reaction (sMAR) with the peroxidase-labelled protein A method (POPA) in infertile patients with varicocele.
Patients, subjects and methods
The study comprised 30 men with a history of varicocele-associated infertility and 30 fertile men (control group). Antisperm antibodies against spermatozoa in the semen and against progenitor spermatozoa in testicular tissue were detected using the two methods.
Results
The tests were positive in 15 (50%) of patients with both the sMAR and the POPA methods, while no autoantibodies were detected in the control group. There were no significant differences between the methods. The sensitivity and specificity of both tests was ≈93%, with no significant difference between them (P>0.05).
Conclusion
Both methods may be used for detecting sperm autoantibodies in infertile patients with varicocele.
12 citations
References
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TL;DR: It was demonstrated that the sperm immobilization test was the best procedure and the sperm-immobilizing factor in patient's serum which gave the strongest positive test was analyzed immunologically.
Abstract: It has long been postulated that human female infertility might be due to an antisperm antibody. Several methods were used to detect the antisperm antibody in the serum of sterile women and it was demonstrated that the sperm immobilization test was the best procedure. Three of 25 women with unexplained sterility showed a positive sperm immobilization test. The sperm-immobilizing factor in patient's serum which gave the strongest positive test was analyzed immunologically. This factor, which was present in the γ-globulin fraction of serum, was not dialyzable. It displayed activity only with complement and was specifically absorbed only by spermatozoa. After absorption to spermatozoa, it was eluted by heat. 131 I-labeled γ-globulin from the patient, absorbed onto sperm and eluted with heat, localized more than twice as much on re-exposure to sperm than did absorbed and eluted 131 I-γ-globulin from normal subjects.
371 citations
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TL;DR: An improved macroscopic test for the detection of agglutinins against human spermatozoa and a medium of increased viscosity containing 2.5% gelatin is described.
Abstract: An improved macroscopic test for the detection of agglutinins against human spermatozoa is described. The technic employs actively motile spermatozoa and a medium of increased viscosity containing 2.5% gelatin. The viscosity of the gelatin medium prevents the dissolution of the weakly bound sperm agglutinates and retards sedimentation. With 7 antihuman sperm rabbits sera this test gave titers ranging from 1:16000 to 1:256000 with a mean of about 1:60000 over 100-fold higher than with ordinary agglutination technics. Evidence as to the specificity of this test is presented. Possible applications of the test are suggested. (authors)
296 citations
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229 citations
Journal Article•
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TL;DR: The percentage of motile spermatozoa found to be coated with antisperm antibody of the IgG class, and the extent of the coating, proved to be correlated with the agglutination titer of circulating antisperm antibodies and with the inhibition of sperm penetration into cervical mucus.
Abstract: A simple and rapid test for the detection of antisperm antibodies of the IgG class on freely swimming spermatozoa in fresh human semen is described. The test is based on the formation of motile mixed agglutinates between erythrocytes sensitized with incomplete anti-Rh-antibodies and freely swimming spermatozoa with surface antisperm antibodies, after mixing both cell types together with anti-IgG antiserum. Agglutination of the red blood cells serves as an internal control. The test can be applied on ejaculates with spermatozoa concentrations down to one million per ml, provided the motility is sufficient. The percentage of motile spermatozoa found to be coated with antisperm antibodies of the IgG class, and the extent of the coating, proved to be correlated with the agglutination titer of circulating antisperm antibodies and with the inhibition of sperm penetration into cervical mucus. The test can be used as a screening for the presence of antisperm autoantibodies in serum and semen.
221 citations
Journal Article•
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TL;DR: Techniques for the detection of iso- and autoantibodies to human spermatozoa and potential application of immunologic techniques in the control of fertility and general investigative methods are discussed.
Abstract: Techniques for the detection of iso- and autoantibodies to human spermatozoa are discussed in detail. The in vitro sperm agglutination tests reviewed include the gelatin agglutination test the capillary tube agglutination test the tray agglutination test the slide agglutination test and the tube-slide agglutination test. Complement-dependent methods include sperm immobilization tests the determination of sperm immobilizing antibody in women the spermatotoxicity test the microtechnique for detection of immobilization and cytotoxicity and the capillary cervical mucus penetration. Tests utilizing labeled antibodies include the indirect immunofluorescent technique for spermatozoa the immunofluorescent staining technique on swollen sperm heads and the localization of antigens on spermatozoa using the immunoperoxidase technique. Immunoelectrophetic quantitation of sperm antibodies by counter immunoelectrophoresis and the leucocyte inhibition test are presented. The potential application of immunologic techniques in the control of fertility and general investigative methods are discussed.
210 citations