Dexamethasone therapy of infertile men with sperm autoantibodies: immunological and sperm follow-up.

A group of 14 infertile men with significant titres of anti-sperm antibodies in their sera and seminal plasma were treated with dexamethasone acetate at 2 of 3 mg/day for s13 or 9 weeks respectively. Response to the treatment was evaluated by the evolution of seminal and circulating anti-sperm antibodies and semen characteristics. An overall decline in the anti-sperm antibodies was observed. Serum spermotoxicity and seminal agglutinins decreased below detectable levels in 67 and 58% of the men respectively. The decrease in both kinds of antibodies was closely correlated. Serum sperm agglutination titres fell slightly (2 to 3 log2 dilutions) in most cases. The disappearance of antibodies from the semen was accompanied by decreased autoagglutination and increased percentages of progressively motile spermatozoa. In two oligozoospermic men a striking increase in the sperm count was observed. Pregnancies occurred in three couples at times when serum spermotoxic and seminal agglutinating antibodies were undetectable and semen characteristics were normal.