In-vitro fertilization in the presence of antisperm antibodies detected by the mixed antiglobulin reaction (MAR) and the tray agglutination test (TAT).

Data from 33 couples suffering from male immune infertility, who underwent 47 in-vitro fertilization (IVF) cycles between January 1989 and August 1991, were retrospectively analysed. The serum of all the 33 male partners had elevated tray agglutination test (TAT) titres (> or = 1:16) and positive mixed antiglobulin reaction (IgG MAR) test results in their semen. There was a slight correlation between these tests in semen and serum. Fertilization rates were analysed in three sperm MAR subcategories. Only the strongly positive MAR group (values > or = 90%) revealed a significant reduction in fertilization rate compared to the other MAR groups. However, this was not observed with increasing serum TAT titres. Fertilization rates were decreased in asthenozoospermic (20.1%) compared to normozoospermic (34.0%) male partners. This occurred also with couples not affected by immunological factors, but when antisperm antibodies were present, the fertilization rates were significantly poorer irrespective of whether the sperm motility was normal or decreased. Once fertilization occurred, the pregnancy rate was not affected by the severity of immunological factors. In assisted reproduction the sperm preparation techniques may reduce the inhibiting effects of antibodies bound to the spermatozoa, and when there are several oocytes to be inseminated, the chance of fertilization rises.