Sperm antigens and autoantibodies: effects on fertility.

There are several antigens of the human sperm cell that can stimulate production of autoantibodies in certain individuals. This occurs in a number of spontaneous cases and leads to a condition of immunological infertility. It also occurs in a majority of men who have had a vasectomy. There are currently many new developments for the detection of the antibody, the study of its significance, and in the treatment of this autoimmune disease. As for the diagnostic testing of the serum, there are the classical methods of agglutination, namely, GAT, TSAT, TAT, and CTAT, and of immobilization. There are also the newer methods of the passive hemagglutination assay, the radio-label-antiglobulin test, the ELISA, the hemadsorption procedure, and the ATP-luminescence cytotoxicity method, plus indirect MAR (mixed antiglobulin reaction) and IBT (immunobead test) procedures. For testing of the genital secretions, sperm cells can be evaluated directly by the MAR and IBT methods, and cervical mucus, after being dissolved, can be tested by the MIS (microscale method) or an indirect IBT procedure. Interpretations of the significance of sperm antibody have been passed on epidemiologic values and also on direct fertilization-inhibition studies. Treatment of the antibody problem has been based on several approaches, but the most promising approach has been the use of intermittent high-dose steroid medication. A number of studies have shown good results by this procedure of immunosuppression.