Mahmoud A M, Tuyttens C L, Comhaire F H
Assiut University Hospital, Department of Dermatology and Andrology, Assiut, Egypt.
Andrologia. 1996 Jul-Aug;28(4):191-6. doi: 10.1111/j.1439-0272.1996.tb02782.x.
A case-control study of clinical, endocrine and seminal characteristics in 86 infertile men and a prospective study of conception rates during 804 follow-up cycles among 75 infertile couples with male immune infertility were performed. Genito-urethral infections or surgery, and palpable epididymal abnormalities were more common among the immunological cases than among the non-immunological infertile controls (n = 180), but sperm concentration, motility and morphology were similar. The spontaneous conception rate in 70 cases was 1.7% per cycle. Treatment by intra-uterine insemination (IUI) resulted in 8.6% pregnancies per cycle, conventional in vitro fertilization (IVF) had a 18.4% success rate per attempt, and two out of three couples treated by intracytoplasmic sperm injection (ICSI) attained pregnancy. Minimal sperm quality required for successful IUI was not lower than that recorded in couples with spontaneous conception. It is concluded that immunological infertility, as diagnosed by a positive mixed antiglobulin reaction (MAR) test, is associated with a low spontaneous conception rate. Techniques of assisted reproduction are useful in the management of couples with infertility resulting from this pathology, but sperm characteristics required for successful IUI are much higher than those needed for successful IVF. A strategy for the logical management of this pathology is proposed.
对86名不育男性的临床、内分泌和精液特征进行了病例对照研究，并对75对患有男性免疫性不育的不育夫妇在804个随访周期中的受孕率进行了前瞻性研究。生殖泌尿系统感染或手术以及可触及的附睾异常在免疫性病例中比在非免疫性不育对照组（n = 180）中更为常见，但精子浓度、活力和形态相似。70例患者的自然受孕率为每个周期1.7%。宫内人工授精（IUI）治疗导致每个周期的妊娠率为8.6%，常规体外受精（IVF）每次尝试的成功率为18.4%，三分之二接受卵胞浆内单精子注射（ICSI）治疗的夫妇成功受孕。成功进行IUI所需的最低精子质量不低于自然受孕夫妇的记录。结论是，通过混合抗球蛋白反应（MAR）试验阳性诊断的免疫性不育与自然受孕率低有关。辅助生殖技术有助于治疗由此病理导致不育的夫妇，但成功进行IUI所需的精子特征远高于成功进行IVF所需的特征。提出了对这种病理进行合理管理的策略。
