Acosta A A, van der Merwe J P, Doncel G, Kruger T F, Sayilgan A, Franken D R, Kolm P
Jones Institute for Reproductive Medicine, Eastern Virginia Medical School, Norfolk 23507.
Fertil Steril. 1994 Oct;62(4):826-33. doi: 10.1016/s0015-0282(16)57012-5.
To investigate the influence of antisperm antibodies on the sperm surface on the outcome of IVF and GIFT.
Matched controlled retrospective review of two large series.
Reproductive endocrine divisions of two level-three academic centers.
Twenty-nine male factor patients (38 IVF cycles) showing positive antisperm antibodies on the sperm by immunobead test treated by IVF at the Norfolk program and 56 similar patients (57 cycles) treated by GIFT at the Tygerberg program. Twenty-nine male factor patients (29 IVF cycles) with negative antisperm antibodies screening matched by wife's stimulation protocol and baseline semen analysis characteristics were used as controls in Norfolk; 56 GIFT patients (56 GIFT cycles) matched similarly were the Tygerberg controls. Study and control groups were divided according to sperm morphology pattern in normal, good, and poor prognosis subgroups for comparison.
Fertilization rate of preovulatory oocytes used in IVF in Norfolk and of GIFT supernumerary preovulatory oocytes in Tygerberg; total and term pregnancy rates (PRs) and abortion rates.
Fertilization rate was significantly lower in the IVF (41.9% +/- 2.8%) as well as in the GIFT (26.8% +/- 3.8%) (mean +/- SE) study groups than in the respective control groups (73.1% +/- 3.9% and 61.8% +/- 3.9%). Total and term PRs in IVF per cycle (21.1% +/- 6.6%; 13.2% +/- 5.5%) and per transfer (23.5% +/- 7.4%; 14.7% +/- 6.1%), and in GIFT (25.0% +/- 5.8%; 19.6% +/- 5.3%) in the study groups were also lower when compared with their control counterparts (IVF per cycle: 62.1% +/- 6.2% and 41.4% +/- 6.0%; IVF per transfer: 41.9% +/- 2.0% and 27.9% +/- 1.9%; GIFT: 31.6% +/- 6.2% and 28.1% +/- 6.0%), but the difference did not reach statistical significance. Abortion rates were similar in the IVF study group (37.5% +/- 17.1%) and its control groups (39.9% +/- 11.5%). The abortion rate in the GIFT study group was 14.3% +/- 9.4%, and no abortions were recorded in the control group (not significant).
The presence of antisperm antibodies on the sperm surface per se impairs the outcome of assisted reproduction, mainly in terms of fertilization rate of preovulatory oocytes, and possibly in terms of total and term PRs. This holds true regardless of the impact of other semen parameters, particularly the morphology of the sperm within the semen sample.
探讨精子表面抗精子抗体对体外受精（IVF）和配子输卵管内移植（GIFT）结局的影响。
对两个大系列进行配对对照回顾性研究。
两个三级学术中心的生殖内分泌科。
在诺福克项目中，29例男性因素患者（38个IVF周期）经免疫珠试验显示精子上抗精子抗体呈阳性，接受IVF治疗；在泰格堡项目中，56例类似患者（57个周期）接受GIFT治疗。在诺福克，29例男性因素患者（29个IVF周期）抗精子抗体筛查为阴性，根据妻子的促排卵方案和基线精液分析特征进行配对，作为对照组；泰格堡的56例GIFT患者（56个GIFT周期）以类似方式配对作为对照组。研究组和对照组根据精子形态模式分为正常、良好和预后不良亚组进行比较。
诺福克IVF中排卵前卵母细胞的受精率以及泰格堡GIFT多余排卵前卵母细胞的受精率；总妊娠率和足月妊娠率（PRs）以及流产率。
IVF研究组（41.9%±2.8%）和GIFT研究组（26.8%±3.8%）（均值±标准误）的受精率显著低于各自的对照组（73.1%±3.9%和61.8%±3.9%）。IVF研究组每周期（21.1%±6.6%；13.2%±5.5%）和每次移植（23.5%±7.4%；14.7%±6.1%）的总妊娠率和足月妊娠率，以及GIFT研究组（25.0%±5.8%；19.6%±5.3%）与各自对照组相比也较低（IVF每周期：62.1%±6.2%和41.4%±6.0%；IVF每次移植：41.9%±2.0%和27.9%±1.9%；GIFT：31.6%±6.2%和28.1%±6.0%），但差异未达到统计学意义。IVF研究组的流产率（37.5%±
