PURPOSE: The requisite presence of active spermatogenesis for antisperm antibody production may be useful in identifying obstructive azoospermia. The diagnostic performance of serum antisperm antibody was evaluated as a test for obstructive azoospermia. MATERIALS AND METHODS: A total of 484 men with male infertility who had undergone antisperm antibody testing were evaluated. Demographic data, patient history, and followup were recorded. Obstruction was confirmed by surgical exploration. Sensitivity, specificity, positive and negative predictive values, and positive and negative likelihood ratios were calculated to quantify diagnostic performance. ROC curves were calculated and compared. RESULTS: Of 484 men 272 possessed documented obstruction of the vas or epididymis and 212 had documented infertility without azoospermia. The obstructed group had significantly increased antisperm antibody levels compared to the nonobstructed group. IgG, IgA, and IgM were analyzed as diagnostic tests for obstruction. The AUC for IgG, IgA and IgM ROC curves was 0.92, 0.85 and 0.67, respectively. The AUC for serum IgG against sperm tails was 0.92, 0.87 against sperm heads and 0.79 against sperm midpieces. IgG demonstrated the highest sensitivity (85%) with a specificity of 97% (chi-square test p <0.01). IgA possessed the highest specificity (99%), positive predictive value (99%) and positive likelihood ratio (70.0). CONCLUSIONS: The presence of serum antisperm antibody was highly accurate in predicting obstructive azoospermia, particularly after vasectomy. It can obviate the need for testis biopsy, the current but more invasive and costly gold standard of detection. This allows the surgeon to proceed directly to surgical reconstruction or sperm retrieval after a simple blood test.
PURPOSE: The requisite presence of active spermatogenesis for antisperm antibody production may be useful in identifying obstructive azoospermia. The diagnostic performance of serum antisperm antibody was evaluated as a test for obstructive azoospermia. MATERIALS AND METHODS: A total of 484 men with male infertility who had undergone antisperm antibody testing were evaluated. Demographic data, patient history, and followup were recorded. Obstruction was confirmed by surgical exploration. Sensitivity, specificity, positive and negative predictive values, and positive and negative likelihood ratios were calculated to quantify diagnostic performance. ROC curves were calculated and compared. RESULTS: Of 484 men 272 possessed documented obstruction of the vas or epididymis and 212 had documented infertility without azoospermia. The obstructed group had significantly increased antisperm antibody levels compared to the nonobstructed group. IgG, IgA, and IgM were analyzed as diagnostic tests for obstruction. The AUC for IgG, IgA and IgM ROC curves was 0.92, 0.85 and 0.67, respectively. The AUC for serum IgG against sperm tails was 0.92, 0.87 against sperm heads and 0.79 against sperm midpieces. IgG demonstrated the highest sensitivity (85%) with a specificity of 97% (chi-square test p <0.01). IgA possessed the highest specificity (99%), positive predictive value (99%) and positive likelihood ratio (70.0). CONCLUSIONS: The presence of serum antisperm antibody was highly accurate in predicting obstructive azoospermia, particularly after vasectomy. It can obviate the need for testis biopsy, the current but more invasive and costly gold standard of detection. This allows the surgeon to proceed directly to surgical reconstruction or sperm retrieval after a simple blood test.
Authors: I Stula; N Družijanić; D Sršen; V Capkun; Z Perko; A Sapunar; D Kraljević; N Bošnjak; Z Pogorelić Journal: Hernia Date: 2012-05-10 Impact factor: 4.739
Authors: Jessica Harakal; Hui Qiao; Karen Wheeler; Claudia Rival; Alberta G A Paul; Daniel M Hardy; C Yan Cheng; Erwin Goldberg; Kenneth S K Tung Journal: Front Immunol Date: 2022-05-26 Impact factor: 8.786
Authors: Sajal Gupta; Rakesh Sharma; Ashok Agarwal; Florence Boitrelle; Renata Finelli; Ala'a Farkouh; Ramadan Saleh; Taha Abo-Almagd Abdel-Meguid; Murat Gül; Birute Zilaitiene; Edmund Ko; Amarnath Rambhatla; Armand Zini; Kristian Leisegang; Shinnosuke Kuroda; Ralf Henkel; Rossella Cannarella; Ayad Palani; Chak-Lam Cho; Christopher C K Ho; Daniel Suslik Zylbersztejn; Edoardo Pescatori; Eric Chung; Fotios Dimitriadis; Germar-Michael Pinggera; Gian Maria Busetto; Giancarlo Balercia; Gianmaria Salvio; Giovanni M Colpi; Gökhan Çeker; Hisanori Taniguchi; Hussein Kandil; Hyun Jun Park; Israel Maldonado Rosas; Jean de la Rosette; Joao Paulo Greco Cardoso; Jonathan Ramsay; Juan Alvarez; Juan Manuel Corral Molina; Kareim Khalafalla; Kasonde Bowa; Kelton Tremellen; Evangelini Evgeni; Lucia Rocco; Marcelo Gabriel Rodriguez Peña; Marjan Sabbaghian; Marlon Martinez; Mohamed Arafa; Mohamed S Al-Marhoon; Nicholas Tadros; Nicolas Garrido; Osvaldo Rajmil; Pallav Sengupta; Paraskevi Vogiatzi; Parviz Kavoussi; Ponco Birowo; Raghavender Kosgi; Saleem Bani-Hani; Sava Micic; Sijo Parekattil; Sunil Jindal; Tan V Le; Taymour Mostafa; Tuncay Toprak; Yoshiharu Morimoto; Vineet Malhotra; Azin Aghamajidi; Damayanthi Durairajanayagam; Rupin Shah Journal: World J Mens Health Date: 2022-01-01 Impact factor: 6.494