The Prognostic Value of Seminal Anti-Sperm Antibodies Screening in Men Prepared for ICSI: A Call to Change the Current Antibody-directed Viewpoint of Sperm Autoimmunity Testing.

Abstract

Objective: To prospectively evaluate the prognostic value of seminal anti-sperm antibodies screening in couples prepared for intracytoplasmic sperm injection.Methods: A prospective comparative study was conducted, including 184 non-azoospermic infertile men scheduled for ICSI. For each patient, detection of anti-sperm antibodies in seminal plasma using ELISA technique was done and its relation to standard semen parameters and ICSI outcomes, including fertilization, embryo development, and pregnancy rates, were analyzed.Results: Sperm count, motility, and morphology were negatively affected by existence of seminal ASA (p=0.012, 0.006, and 0.011, respectively). However, no statistically significant difference was detected between patients with positive and negative seminal ASA regarding the median values of fertilization (56.3% Vs. 66.7%, p =0.091), percentage of couples with grade A embryo development (91.4% vs. 89.9%, p= 0.520), and pregnancy rates (31.4% vs. 32.2%, p =0.98) after ICSI.Conclusion: ICSI seems able to overcome the problem of ASA in semen. The routine screening of ASA in men prepared for ICSI has no additional prognostic value and cannot be recom­mended for the time being, until more specific antigen-concerned testing can be developed.