Relationship between genital tract infections, sperm antibodies in seminal fluid, and infertility.

To explore possible relationships between genital tract infections, sperm antibodies, and infertility, seminal fluid from 100 men was analyzed. Sperm antibodies, measured by an enzyme-linked immunosorbent assay, were detected in 14 of 29 men (48%) with culture-positive asymptomatic infections, 8 of 17 men (47%) with a history of prostatitis or urethritis, 11 of 33 men (33%) with either a varicocele or an abnormal semen analysis, and only 1 of 21 men (5%) with no infection and a normal semen analysis. The incidence of sperm antibodies in the men with infections or urethritis or prostatitis was significantly higher than in the control subjects (P less than 0.005). The sperm antibody isotype in men with infections was mainly IgA, although IgG or IgM were also sometimes present. Of the men with asymptomatic infections, urethritis or prostatitis, significantly (P less than 0.025) more men without sperm antibodies (12 of 24, 50%) were fertile than were those with sperm antibodies (3 of 22, 13%). Men with genital tract infections have a high incidence of antibodies, reactive with spermatozoa, which is associated with reduced fertility.