Detection and treatment of antispermatozoal antibodies in men.

Autoimmunity to spermatozoa results in the production of antisperm antibodies that usually reduce the fertility of human males. Many laboratory tests have been devised to detect antisperm antibodies, but the results of such tests do not always correlate well with each other, particularly when the tests are conducted with patients' own spermatozoa rather than donor sperm. Experience over the past 12 years at Chelsea Hospital for Women and St Bartholomew's Hospital in London has led to at Chelsea Hospital for Women and St Bartholomew's Hospital in London has led to the development of an effective method for testing and treating subfertile males. This involves using the mixed antiglobulin reaction test and the post-coital test as initial screening tests, followed by serum and seminal plasma agglutination tests (both gelatin and tray) and the sperm-cervical mucus contact tests. Suitable patients are then put on one of three steroid regimens--long-term low-dose prednisolone, intermittent high-dose methylprednisolone, or intermediate graduated-dose prednisolone. Such treatment is useful not only in cases of spontaneous autoimmunity, but also in cases involving genital infection, testicular obstruction, and in vitro fertilization or gamete intrafallopian transfer.