Andrology: Results of 55 intracytoplasmic sperm injection cycles in the treatment of male-immunological infertility

Abstract

Antisperm antibodies present in the semen can be a primary cause of infertility. If the proportion of spermatozoa carrying antisperm antibodies is very high, then usually a poor result ensues in standard in-vitro fertilization. We therefore employed intracytoplasmic sperm injection (ICSI) in 55 cycles (37 patients) where the proportion of antisperm antibody-bound spermatozoa was 80% or higher, as determined by the mixed antiglobulin reaction (MAR) test. The type and location of antisperm antibodies were determined by the immunobead test in 30 of the 37 patients. The mean normal fertilization rate was 75.7% in these 55 cycles, which was significantly higher than the fertilization rate in another 1767 ICSI cycles (69.2%) performed over the same period and where MAR-negative semen (the level of antisperm antibodies was < 80%) was used for microinjection. Embryonic development was comparable, but a higher proportion of poor-quality embryos was obtained with MAR-positive than with MAR-negative semen samples. Out of the 55 patients, 53 had embryos replaced (96.4%) and a fetal sac was detected by ultrasonography in 14 patients (26.4%). The data indicate that fertilization, embryo development and pregnancy rates after ICSI are not influenced significantly by the proportion of antisperm antibody-bound spermatozoa, nor by the dominant type of antibodies present, nor by the location of the antisperm antibody on the spermatozoa. The conclusion of this study is that ICSI should be the primary choice for patients who have high numbers of antisperm antibodies present in their semen.

Male factor infertility and ART

“…In addition, some authors believe that the presence of significant levels of antisperm antibodies is an indication to always perform ICSI, 42,43 despite a recent meta-analysis concluding that there is no benefit of ICSI over IVF in cases of antisperm antibody-mediated male factor infertility. 44 For cryopreserved sperm from cancer patients, no prospective comparative studies pitting the use of IVF versus ICSI are available in the literature.…”

Advances and Controversies in Assisted Reproductive Technology

“…42 The pregnancy rates in the former treatments are somewhat diminished, whereas the use of ICSI offers patients success rates as high as those of non-ASAaffected couples undergoing conventional IVF. 43 Unexplained Infertility.…”

Effects of Sperm Treatment on the Anti-sperm Antibodies IgG and IgA

“…However, in the most severe cases the Intracytoplasmic Sperm Injection (ICSI) is generally recommended. Indeed, Naggy et al (1995) demonstrated that there was no significant difference of pregnancy rates resulting from ICSI practice with antibody levels above 80% and those with negative ASA tests. However, the number of poor quality embryos was higher among those with ASAs greater than 80% [17].…”

“…Indeed, Naggy et al (1995) demonstrated that there was no significant difference of pregnancy rates resulting from ICSI practice with antibody levels above 80% and those with negative ASA tests. However, the number of poor quality embryos was higher among those with ASAs greater than 80% [17]. If the sperm parameters are normal according to the recommendations of the WHO 2010, the preparation of semen in view IIU is recommended, in case where the parameters are deleterious the therapeutic indication are the IVF and ICSI.…”