Francavilla F, Romano R, Santucci R, Marrone V, Corrao G
Department of Internal Medicine, University of L'Aquila, Medical School, Italy.
Fertil Steril. 1992 Sep;58(3):587-92.
To determine if the overcoming of the cervical mucus barrier removes the interference of sperm-bound antibodies with fertility.
Prospective case series.
University-based intrauterine insemination (IUI) homologous program.
Nineteen patients with all spermatozoa in the ejaculate coated by antisperm antibodies. As control group, 86 consecutive patients without antisperm antibodies, treated for oligoasthenozoospermia or mucus hostility.
Intrauterine inseminations (at least 3 attempts per couple).
The outcome of IUIs, demographic, and seminal parameters were compared between the two groups.
No pregnancy occurred in the couples with male immunological infertility, treated by 110 IUIs. Twenty-three pregnancies occurred in 22 (25.6%) of the control group couples who were treated by 411 IUIs. In the group of patients without antisperm antibodies, we demonstrated that the pregnancy rate (PR)/couple in oligoasthenozoospermia without teratozoospermia was similar to that achieved in normozoospermia (35% versus 38.9%), whereas it was significantly affected by teratozoospermia (3.6%). Only three patients with antisperm antibodies had teratozoospermia. Comparing the PR per couple and per cycle between the two groups of patients (with and without antisperm antibodies), excluding the patients with teratozoospermia, significant differences resulted (P less than 0.005 and P less than 0.005, respectively). The motile sperm count was not significantly different between the two groups, which also resulted to be homogeneous for demographic data. Moreover, the motile sperm count was not different between the patients with and without antisperm antibodies, who had successful IUI.
The analysis of this trial suggests that the failure of IUI in the treatment of male immunological infertility is imputable to antisperm antibodies when they involve all spermatozoa, regardless of semen quality.
确定克服宫颈黏液屏障是否能消除精子结合抗体对生育能力的干扰。
前瞻性病例系列研究。
基于大学的宫内人工授精（IUI）同源项目。
19例射精液中所有精子均被抗精子抗体包裹的患者。作为对照组，86例连续的无抗精子抗体患者，因少弱精子症或黏液不相容而接受治疗。
宫内人工授精（每对夫妇至少进行3次尝试）。
比较两组患者宫内人工授精的结果、人口统计学和精液参数。
接受110次宫内人工授精治疗的男性免疫性不育夫妇均未怀孕。对照组411次宫内人工授精治疗的22对夫妇（25.6%）中有23例怀孕。在无抗精子抗体的患者组中，我们发现无畸形精子症的少弱精子症夫妇的妊娠率（PR）/夫妇与正常精子症夫妇相似（35%对38.9%），而畸形精子症则对其有显著影响（3.6%）。只有3例有抗精子抗体的患者有畸形精子症。比较两组患者（有和无抗精子抗体）每对夫妇和每个周期的PR，排除有畸形精子症的患者，结果有显著差异（分别为P<0.005和P<0.005）。两组之间的活动精子计数无显著差异，人口统计学数据也显示两组具有同质性。此外，宫内人工授精成功的有和无抗精子抗体的患者之间的活动精子计数也无差异。
该试验分析表明，当抗精子抗体涉及所有精子时，宫内人工授精治疗男性免疫性不育失败可归因于抗精子抗体，而与精液质量无关。
