Immunologic infertility: identification of patients with antisperm antibody.

Immunologic causes of infertility have been postulated for many years, but a precise means for identification of men or women with antibodies against sperm has not been available. We studied 614 patients, including 257 couples, with unexplained in fertility, to detect the presence of circulating antisperm antibody. Using a specific radiolabeled-antiglobulin test, we identified a subset of patients (10 per cent) with IgG antisperm antibody; this antibody was present in 13 per cent of the women and 7 per cent of the men. We followed the course of six infertile couples in whom one partner had sperm antibody. In four couples, pregnancy was achieved; pregnancy correlated with resolution of antibody activity. In two of these four couples the partner (one man and one woman) with antisperm activity had been pretreated with corticosteroids. We conclude that this objective test may be used to identify and then to help manage infertility in patients with suspected antibody-mediated infertility.