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Circulating antisperm antibodies and fertility prognosis: a prospective study.

In a prospective study performed on 235 couples with long-standing infertility (median 5 years), circulating antisperm antibodies (ASA) were determined with both a standard trayagglutination test (TAT) and a radioimmunoassay (RIA). Serum levels were correlated with results of sperm analysis (SA), postcoital testing (PCT) and in-vitro sperm--cervical mucus penetration testing (SCMPT), performed with cervical mucus and spermatozoa of patients and in parallel with material of fertile donors. A simultaneous microbial screening included Chlamydia trachomatis, mycoplasmas, Herpes simplex virus, gonococci, other potentially pathogenic aerobic and anaerobic bacteria and yeasts. The pregnancy rate 12 months after determination of ASA in the serum samples was 27% (64/235). Between ASA-positive and -negative male and/or female patients (TAT as well as RIA), no significant difference was found for any of the tested variables of SA, PCT, crossed SCMPT and colonization of genital secretions with microorganisms. Patients who later achieved pregnancy and those who did not did not differ with regard to serum antibody status (TAT as well as RIA). The findings suggest that the clinical significance of circulating ASA determined with the currently available methods is low. ASA in serum samples of infertile female and/or male patients do not influence the fertility prognosis.