[Successful application of in vitro fertilization and embryo replacement in the treatment of infertile women with sperm immobilizing antibody].

Thirteen infertile patients (18 cycles) with sperm immobilizing antibodies were subjected to in vitro fertilization and embryo replacement (IVF-ER) therapy during 12 months from January to December 1985. Four patients became pregnant, two of them delivered healthy babies at term and 2 had abortions at 5 weeks and 12 weeks of gestation, respectively. In the same duration, 24 patients (28 cycles) with tubal factor and 4 patients (5 cycles) with male factor for infertility were subjected to IVF-ER, and two patients with tubal factor became pregnant and delivered healthy babies at term. In the patients with immunological factor, fertilization and cleavage rates per mature oocyte were 85.9% (55 fertilized/64 oocytes) and 81.3% (52 cleaved/64 oocytes) respectively, while the fertilization rates in patients with tubal factor and male factor were 70.5% (62 fertilized/88 oocytes) and 50.0% (6 fertilized/12 oocytes) respectively and all fertilized eggs in these patients developed to the cleavage stage. Thus fertilization and cleavage rates for mature oocytes from the patients with the immunological factor were slightly better than those with the tubal factor and much better than those with the male factor. The antisperm antibody titers (SI50) in sera determined by the quantitative sperm immobilization test ranged from 20 to 243 units while those in follicular fluids ranged from 21 to 160 units in the patients with the immunological factor. The follicular sperm immobilizing antibodies could be detected in any patient who had the antibodies in the serum. Immunoglobulin (IgG, IgA, IgM) concentrations in follicular fluids were not significantly different from each other in the patients with immunological, tubal and male factor for infertility.