Immune infertility and new approaches to treatment.

A number of patients who have involuntary infertility show sperm antibodies in the blood serum, as detected by two quite different methods of spermagglutination. These techniques are the Kibrick method (gelatin agglutination test) and the F-D method (tube-slide agglutination test). By the former technique, the sera of 18% of women and 9% of men from infertile couples were found to be positive; by the latter technique, the sera of 15% of women and 5% of men were positive. Such cases are termed "immunologic infertility." In an effort to develop new methods for the treatment of infertility, two procedures were explored. One is a sperm washing insemination method in which fresh semen from a man with the antibody is centrifuged, resuspended in an albumin solution, and then used for insemination. The second is an immunosuppression method, using methylprednisolone at a dose of 96 mg/day for 7 days. A striking decrease in antibody level was seen in some cases, with ensuing pregnancy. The success rates for these methods have been of the order of 14% to 22%.