Background: To evaluate the improvement of the term delivery rate after uterine surgery in various uterine malformations. Methods: 170 patients were eligible for the present retrospective case series study. Data were weighted for the number of pregnancies observed (n = 218) after surgical intervention, stratified to the number of previous abortions (at least 2) and type of malformation. Results: Before surgery, the overall term delivery rate was 5.5%. After surgery, the overall term delivery rate was 59% (absolute benefit increase, ABI, was 54.5) and correlated with the number of previous abortions (69.7% ABI = 64.2, 56.5% ABI = 51 and 26.3% ABI = 20.8 for 2, 3–4 and >4 abortions, respectively; p = 0.0008, log-rank test). Data stratified according to uterine malformations yielded the following term delivery rate: 66.7% for T-shaped uterus, 62.8% for septum/partial septum and 55.6% for arcuate uterus (NS, log-rank test). The number of previous abortions and maternal age also affected the term delivery rate. Their effect upon the term delivery rate, expressed as an odds ratio, was 1.73 (95% CI: 1.20–2.49) and 1.11 (95% CI: 1.05–1.18), respectively. Conclusion: The term delivery rate was about 10-fold higher after surgery. T-shaped uterus surgery yielded the best term delivery rate.

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These findings show: a) a lack of IL-4 in seminal plasma; b) similar SIL-2R levels in fertile and infertile seminal plasma; c) increased IL-6 secretion in seminal plasma of infertile subjects; and d) specific correlations of IL-6 with the main semen parameters.

Immunoblotting techniques were used to characterize the reactivity of human sperm antigens with sperm antibodies from an infertile population. Sperm antigens of each individual were tested with autologous sperm antibodies present in serum and seminal plasma in order to construct a preliminary map of the antigens of the infertile spermatozoon and to compare the qualitative differences in the antigenic profile between fertile and infertile subjects. A total of 61 infertile males, comprising 51 subjects having poor semen quality and 10 subjects with no abnormalities in semen analysis, entered the study; 55 subjects with proven fertility served as controls. Infertile subjects often showed specific immunoreactivity to 50-, 55-, 57-, 62-, and 72-kDa proteins in serum and to 57- and 62-kDa proteins in seminal plasma. As to comparison of immunoreactivities between fertile and infertile individuals, the sperm antigens may be divided into three groups. Group 1 antigens (50-, 69-, and 72-kDa proteins) were recognized by sperm antibodies present in both populations; group 2 antigens (57- and 62-kDa proteins), by sperm antibodies typical of the infertile population; group 3 antigens (45-, 55-, and 85-kDa proteins), by sperm antibodies typical of the fertile population. This classification shows that the infertile spermatozoon differs substantially at the immunogenic level from the fertile spermatozoon. The group 2 antigens seem to be involved in a relevant step in the reproductive process and hence have been termed "fertility-related antigens."

The role of cell-mediated immunity in the etiopathogenesis of male infertility is far from being defined. The cytokine interleukin-2 (IL-2) has a key role in T-cell mediated immune responses. The aim of this study was to confirm the presence of IL-2 in human seminal plasma, to show eventual differences between IL-2 concentrations in fertile and infertile subjects, and to show potential relationship between IL-2 amounts in semen and spermiogram parameters. Forty-three subjects entered the study, 20 with proven fertility and normal semen quality (fertile group) and 23 with male infertility of at least 2 years and poor semen quality (infertile group). IL-2 levels of seminal plasma in infertile subjects (444.3 +/- 40.5 fmol/mL) were significantly higher than those in fertile subjects (251.3 +/- 42.7 fmol/mL). There was a significant negative correlation between IL-2 levels and sperm count, motility, and morphology. No correlation was found between IL-2 levels and leukocyte count. These findings confirm IL-2 to be in seminal plasma, show increased IL-2 secretion in the infertile group, demonstrate negative correlations of IL-2 levels with main spermiogram parameters, and indicate no correlation with leukocyte count. IL-2 concentration in seminal plasma may therefore be considered as a potential marker in male infertility.