The epidemiology of antisperm antibodies among couples of unexplained infertility in North West Bank

Supervisor:

Dr. Walid Basha 

Abstract:

Background: Infertility is one of the most common and important subjects in today‟s obstetrics and gynecology. Immunological factors such as the presence of antisperm antibodies (ASA) are challenging etiologies for infertility. However, Many questions still remain on the role of ASA in reproduction and there is little consensus about their prevalence, significance, associated risk factors and implications on management strategies of infertility. This study is performed to determine the prevalence of ASA in serum of infertile couples due to unexplained infertility and to give a glance about their risk factors and effects on treatment.

Methods: A cross sectional study was conducted on 42 normal infertile couples consulting Razan Medical Center for Infertility & I.V.F. – Nablus from December 2012 – March 2013. Serum levels of immunoglobulins G type (IgG) were measured in the participants (males and females) using enzyme-linked immunosorbent assay (ELISA), a level >60U/ml considered positive. Participants also filled a questionnaire about previous varicocele, inguinal hernia repair, orchitis, testicular trauma and vasovasostomy among males and severe coitus bleeding and coitus during menses or puerperium among females, couples are also asked about previous intrauterine insemination (IUI) or in vitro fertilization – intracytoplasmic sperm injection (IVF-ICSI) procedures. Data are analyzed using SPSS software.

Results: ASA were positive in 14.3% (6/42) of all couples, 9.5% (4/42) among males and 4.8% (2/42) among females. There was no significant relationship between previous varicocele repair, previous inguinal hernia repair, or orchitis and formation of ASA (P-value: 0.64, 0.56, and 0.26 respectively). Previous trauma, vasovasostomy, severe coitus bleeding and coitus during menses or puerperium are not observed in any of the study sample. ASA do not seem to affect the outcome of IUI or IVF-ICSI (P-value: 0.35 and 0.54 respectively).

Conclusion & Recommendation: Prevalence of ASA in north part of Palestine is similar to that obtained world wide and most cases are idiopathic. ASA testing is not recommended as part of IUI or IVF-ICSI. I recommend further studies by using larger sample for all parts of Palestine in order to generalize results.