Antisperm Antibodies May Not Adversely Influence ART Pregnancy Rates

Literature searches on the link between direct semen antisperm antibody (ASA) levels and treatment outcomes in ART cycles have not yielded clear results. Now, a systemic review suggests that semen ASA is not associated with pregnancy rates after IVF or ICSI cycles, thereby indicating the effectiveness of such ART strategies in infertile couples with raised ASA titres.

Armand Zini from the Division of Urology, Department of Surgery, McGill University, Montreal, Canada, and colleagues, conducted the systemic review using the Medline database, and short-listed 10 IVF and 6 ICSI studies to investigate the impact of ASA on pregnancy rates after IVF/ICSI. The ASA cut-off levels were heterogeneous in the study. The analysis demonstrated that the combined OR for failing to achieve pregnancy with IVF and ICSI were 1.22 (95% CI=0.84, 1.77) and 1.00 (95% CI=0.72, 1.38), respectively, in patients with positive semen ASA. The OR for the combined results of IVF and ICSI cycles was found to be 1.08 (95% CI=0.85, 1.38). Based on the study findings, the scientists concluded that IVF/ICSI pregnancy rates are not affected by the presence of ASA in semen. The findings of the study are published in the online issue of Human Reproduction.

Similar results were reported in another recent retrospective study by Zini et al (Journal of Reproductive Immunology, 2011). The researchers analyzed consecutive IVF and IVF/ICSI cycles, in which the patients underwent seminal test for ASA within 6 months before ART cycle. The clinical pregnancy rates in ASA positive couples did not significantly vary from ASA negative samples (42% vs. 52%; OR=1.45; 95% CI=0.63, 3.30; P>0.05). The findings revealed that reproductive outcomes were not linked to direct ASA levels or sperm parameters such as concentration, motility, and strict morphology.

ASA may hinder the sperm’s fertilization ability, resulting in immunological infertility, and can also potentially hamper the success of different fertilization techniques. Several studies have been conducted to determine the effectiveness of various treatments, such as corticosteroids, vitamin D3, IUI, IVF, and ICSI, for improving reproductive results in infertile couples with positive ASA, but there is still a lack of consensus on the best approach.

Although the current study findings indicate that IVF/ICSI pregnancy rates may not be associated with ASA, the researchers suggest the need for further well-designed prospective studies to validate the results by using appropriate cut-off values of ASA. Furthermore, there is also a need for continuing research on the sperm and oocyte antigenicity, apart from male and female reproductive tract immunology, to enhance knowledge on the underlying mechanisms for immunologic infertility. This will, in turn, aid in developing new, cost-effective, and specific treatment for such infertile couples.

References

1. Zini A, Fahmy N, Belzile E, Ciampi A, Al-Hathal N, Kotb A. Antisperm antibodies are not associated with pregnancy rates after IVF and ICSI: systematic review and meta-analysis. Hum Reprod. 2011 Jun;26(6):1288-95.

2. Zini A, Lefebvre J, Kornitzer G, et al. Anti-sperm antibody levels are not related to fertilization or pregnancy rates after IVF or IVF/ICSI. J Reprod Immunol. 2011 Jan;88(1):80-4.

3. Bubanovic I, Najman S, Kojic S. Immunomodulatory Treatment for Infertile Men with Antisperm Antibodies. Fertil Steril. 2004;81(3):S7-31:20.

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