Glazener C M, Hull M G
University of Bristol Department of Obstetrics and Gynaecology, Bristol Maternity Hospital, UK.
Hum Reprod. 1987 Nov;2(8):673-7. doi: 10.1093/oxfordjournals.humrep.a136613.
In 94 infertile couples with negative postcoital tests (PCTs) the results of an in-vitro sperm-mucus invasion test (SMIT) were compared with seminal analysis (excluding sperm density less than 1 x 10(6)/ml) and agglutination assays for antisperm antibodies in semen (MAR, TAT) and in mucus (TAT). Abnormalities at the sperm-mucus interface were classed into three types. (i) Failure to form semen clefts and of spermatozoa to colonize the clefts was closely correlated with oligo-asthenoteratozoospermia, and vice versa, the two tests agreeing in 90% of cases (P less than 0.001). Most of the discrepancies, in which sperm-dense clefts developed despite low sperm counts, were due to antisperm antibodies in semen. (ii) Failure of spermatozoa to invade mucus, despite normal sperm colonization of clefts, was closely correlated with the presence of antisperm antibodies in semen (positive MAR or TAT), and vice versa, the tests agreeing in 81% of cases (P less than 0.001). (iii) Failure of sperm survival after normal invasion of mucus could not be correlated significantly with the TAT results on mucus, but more extensive study of this question is needed. Finally a normal SMIT result was associated with a significantly improved chance of conception (39 versus 10% at 12 months), particularly with artificial insemination, suggesting undisclosed coital failure as the cause of the negative PCT. In conclusion, the invasion test, when assessed in the foregoing detail, offers a reliable and simple substitute for laboratory assessment of both seminal quality and the presence of antisperm antibodies in semen, and would be applicable in general infertility practice everywhere.
在94对性交后试验（PCT）结果为阴性的不育夫妇中，将体外精子-黏液侵入试验（SMIT）的结果与精液分析（不包括精子密度低于1×10⁶/ml的情况）以及精液（MAR、TAT）和黏液（TAT）中抗精子抗体的凝集试验结果进行了比较。精子-黏液界面的异常分为三种类型。（i）未能形成精液裂隙以及精子未能在裂隙中聚集与少弱畸精子症密切相关，反之亦然，两种试验在90%的病例中结果一致（P<0.001）。大多数差异情况，即尽管精子数量少但仍出现精子密集的裂隙，是由于精液中存在抗精子抗体。（ii）尽管精子在裂隙中正常聚集，但精子未能侵入黏液与精液中存在抗精子抗体（MAR或TAT阳性）密切相关，反之亦然，两种试验在81%的病例中结果一致（P<0.001）。（iii）精子在正常侵入黏液后未能存活与黏液的TAT结果无显著相关性，但需要对这个问题进行更广泛的研究。最后，正常的SMIT结果与受孕几率显著提高相关（12个月时为39%对10%），特别是在人工授精时，提示未发现的性交失败是PCT阴性的原因。总之，如上述详细评估的侵入试验，为精液质量和精液中抗精子抗体的实验室评估提供了一种可靠且简单的替代方法，并且适用于各地的一般不育症诊疗实践。
