Antisperm antibodies: Incidence, isotypes and location on spermatozoa, their implications on fertilization and on pregnancy rate at a selected centre in Sri Lanka

Objectives: 1. To investigate the incidence, isotypes and location of antisperm antibodies (ASA) on the sperm surface in an infertile population. 2. To study the influence of isotypes, location of ASA on the sperm surface on fertilization, cleavage rates of embryos and pregnancy rate. Methods: A prospective analytical study was carried out on infertile couples who underwent Assisted Reproductive Technology (ART) procedures at ‘Prarthana’ Centre for in vitro fertilization (IVF) during three year period from 01.01.2006 – 01.01.2009. Presence of ASA was elicited using mixed agglutination reaction latex bead test (Sperm MAR, Fertipro NV, Belgium) in male and female subjects. The isotype and location of ASA, detected by the type (i.e. IgA, IgG) and the site of binding of latex beads to ASA on the spermatozoa (i.e. head, midpiece, tail of the sperm) was analyzed. In females who underwent In-vitro fertilization, fertilization rate and day 03 cleavage rate of embryos were assessed. The pregnancy rates following each ART procedure were noted. A total of 230 infertile couples were investigated. Results: Out of 230 couples, 48 (20.86%) were positive for ASA. Among ASA positives, 19 (39.58%), 13 (27.08%), 16 (33.34%) had IgA, IgG, both IgA, IgG respectively and 10 (20.83%), 24 (50%), 11 (22.92%), 03 (6.25%) had head, tail, midpiece+tail, whole sperm bound ASA Antisperm antibodies: Incidence, isotypes and location on spermatozoa, their implications on fertilization and on pregnancy rate at a selected centre in Sri Lanka Varuni Tennakoon1 Surangi G Yasawardene2 Deepal S Weerasekera3 Sri Lanka Journal of Obstetrics and Gynaecology 2010; 32: 8-16 1,3 Prarthana Centre for ART, Rajagiriya, Colombo. 2 Dept. of Anatomy, Faculty of Medical Sciences, University of Sri Jayawardenepura, Gangodawila, Nugegoda. Correspondence: Varuni Tennakoon E-mail: [email protected] Research respectively. The total fertilization rate and cleavage rate among ASA positives were 69.38% (179/258) and 53.63% (96/179) respectively; and among ASA negatives the rates were 58.54% (473/808) and 61.73% (292/473) respectively. Couples with IgA, IgG and IgA+IgG achieved a pregnancy rate of 10.53%, 23.08% and 18.75% respectively. Out of 08 pregnancies 05, 02, 01 had ASA on tail, midpiece+tail and whole sperm respectively. Conclusions: It was found that presence of ASA has negative effects on fertilization and post fertilization events. IgA isotype of ASA demonstrated the lowest pregnancy rate. When majority of sperms are coated with ASA on the heads or mid piece+tail, cleavage rates were often impaired. Intra-cytoplasmic sperm injection is recommended for such couples to achieve a successful pregnancy.