Cookson M S, Witt M A, Kimball K T, Grantmyre J E, Lipshultz L I
Scott Department of Urology, Baylor College of Medicine, Houston, TX 77030, USA.
World J Urol. 1995;13(5):318-22. doi: 10.1007/BF00185976.
A retrospective study was performed to evaluate the ability to predict sperm-surface antisperm antibodies (ASA) in patients with primary infertility on the basis of semen analysis. In particular, the ability to predict ASA status on the basis of impaired sperm motility was assessed. The clinical and seminal characteristics of 70 consecutive ASA-positive infertility patients detected by routine screening were reviewed. Similar analysis was performed on 128 consecutive patients with infertility who were found on routine screening to be ASA-negative. The association between the presence of ASA and sperm motility, concentration, and clumping was examined using multivariate analysis. Two variables were found to have a significant joint association with the presence of ASAs. Patients with sperm concentrations of > 20 million/ml were significantly more likely to be ASA-positive (P = 0.002). Second, after adjustment for sperm concentration, patients with lower motilities were significantly more likely to be ASA-positive (P = 0.016). Although impaired motility was seen significantly more often in ASA-positive patients, this seminal defect alone should not be used for predictive screening, since 39% of ASA-positive patients had sperm motilities of > 60%. Furthermore, when a normal sperm concentration (> 20 million/ml) was combined with impaired sperm motility (< 60%) as an indication for ASA testing in this population, the result was a sensitivity of only 43%, a specificity of 77%, and positive and negative predictive values of 50% and 77%, respectively. Despite the association between normal sperm concentrations and impaired motility, it appears that the results of semen analysis cannot be used as a sole indication for ASA testing.
进行了一项回顾性研究，以评估基于精液分析预测原发性不孕患者精子表面抗精子抗体（ASA）的能力。特别是，评估了基于精子活力受损预测ASA状态的能力。回顾了通过常规筛查检测出的70例连续ASA阳性不孕患者的临床和精液特征。对通过常规筛查发现为ASA阴性的128例连续不孕患者进行了类似分析。使用多变量分析检查了ASA的存在与精子活力、浓度和凝集之间的关联。发现有两个变量与ASA的存在有显著的联合关联。精子浓度>2000万/ml的患者显著更有可能为ASA阳性（P = 0.002）。其次，在调整精子浓度后，活力较低的患者显著更有可能为ASA阳性（P = 0.016）。尽管在ASA阳性患者中显著更常出现活力受损，但仅这种精液缺陷不应用于预测性筛查，因为39%的ASA阳性患者精子活力>60%。此外，当将正常精子浓度（>2000万/ml）与精子活力受损（<60%）结合作为该人群ASA检测的指标时，结果是敏感性仅为43%，特异性为77%，阳性和阴性预测值分别为50%和77%。尽管正常精子浓度与活力受损之间存在关联，但精液分析结果似乎不能用作ASA检测的唯一指标。
