Zouari R, De Almeida M, Rodrigues D, Jouannet P
Centre Hospitalo-Universitaire de Bicêtre, Kremlin-Bicêtre, France.
Fertil Steril. 1993 Mar;59(3):606-12. doi: 10.1016/s0015-0282(16)55808-7.
To define sperm factors related to in vitro fertilization (IVF) failure in cases of antisperm autoimmunity.
A detailed analysis of sperm morphology, movement characteristics, acrosomal function, and antibody binding was performed on the sperm population selected on a discontinuous two-layer Percoll gradient and used for IVF. The results were compared retrospectively between fertilizing (n = 13) and nonfertilizing (n = 11) sperm populations.
Twenty-one infertile couples undergoing 24 cycles of IVF treatment because of antisperm autoimmunity were included in this study.
Fertilizing and nonfertilizing sperm populations were not different with respect to the percentage of motility, the normal morphology, the multiple anomalies index, the acrosome abnormalities, and the spontaneous or induced acrosome reaction. If the proportion of spermatozoa coated with either immunoglobulin (Ig)A or IgG antibodies was similar in the two groups, their localization was often different: antibodies were mainly on the sperm heads in the cases of fertilization failure. There were significant differences between fertilizing and nonfertilizing sperm samples in several movement parameters. Among them, the amplitude of lateral head displacement (ALH) was the most significantly correlated with fertilization success. Finally, spermatozoa were poorly bound to the zona pellucida (ZP) when fertilization failed, whereas high numbers of spermatozoa were attached to the ZP when fertilization occurred.
Fertilization failure in patients with antisperm antibodies may be the result of several factors in which the impact of the antibodies on the membrane function play a critical role. Movement parameters, particularly the ALH and the localization of antibodies on migrated spermatozoa could predict the IVF failure or success more accurately than the proportion of antibody-coated spermatozoa in the inseminated populations. The fertilization failure was associated with an incapacity of spermatozoa to bind to ZP.
确定抗精子自身免疫情况下与体外受精（IVF）失败相关的精子因素。
对在不连续双层Percoll梯度上选择并用于IVF的精子群体进行精子形态、运动特征、顶体功能和抗体结合的详细分析。对受精（n = 13）和未受精（n = 11）精子群体的结果进行回顾性比较。
本研究纳入了21对因抗精子自身免疫而接受24个周期IVF治疗的不育夫妇。
受精和未受精精子群体在活力百分比、正常形态、多重异常指数、顶体异常以及自发或诱导顶体反应方面没有差异。如果两组中被免疫球蛋白（Ig）A或IgG抗体包被的精子比例相似，其定位通常不同：受精失败时抗体主要位于精子头部。受精和未受精精子样本在几个运动参数上存在显著差异。其中，头部侧向位移幅度（ALH）与受精成功最显著相关。最后，受精失败时精子与透明带（ZP）的结合较差，而受精时大量精子附着于ZP。
抗精子抗体患者的受精失败可能是多种因素的结果，其中抗体对膜功能的影响起关键作用。运动参数，特别是ALH以及迁移精子上抗体的定位比授精群体中抗体包被精子的比例更能准确预测IVF的失败或成功。受精失败与精子无法结合ZP有关。
