THE VALUE OF ROUTINE SCREENING OF FEMALE SERUM FOR ANTISPERM ANTIBODIES IN ASSISTED REPRODUCTIVE TECHNOLOGY CYCLES

Objective: To determine the effect of antisperm antibodies in the female serum on fertilization and pregnancy rates (PRs) in assisted reproductive technology (ART) cycles. Design: Retrospective case control study. Setting: Assisted reproductive technology program at North Shore University Hospital. Patients, Participants: All patients undergoing an ART cycle in 1990 whose husbands did not have significant antisperm antibodies in the semen. Thirty-four female patients had significant antisperm antibodies level in the serum (antisperm antibodies-significant); 62 patients with no antibodies or nons ignificant levels constituted the control group (antisperm antibodies-negative). Incubation media were prepared with maternal serum in 37 of the antisperm antibodies-negative and in 10 of the antisperm antibodies-positive patients, whereas donor's serum (DS) was used for 25 and 24 patients, respectively. Main Outcome Measures: Fertilization rate and clinical PR, defined as an intrauterine sac by transvaginal ultrasonography, were recorded for each group. Results: Analysis of variance showed a significant interaction between antisperm antibodies grouping and the type of media used, with fertilization rate in antisperm antibodies-significant patients significantly higher with maternal serum than with DS, whereas fertilization rate in antisperm antibodies-negative was quantitatively, though not statistically lower with maternal serum than with DS. When maternal serum was used, fertilization was higher in antisperm antibodies-significant than antisperm antibodies-negative. Of 29 clinical pregnancies, 11 were in antisperm antibodies-significant and 18 in antisperm antibodies-negative. In 10 of the pregnancies, maternal serum was used, whereas in 19 pregnancies DS was used. No variable was significantly predictive of pregnancy in the logistic regression analysis. Conclusions: [1] Female patients with significant levels of antisperm antibodies in the serum had similar fertilization rates as patients with nonsignificant levels if DS was used. [2] The use of maternal serum in antisperm antibodies-significant patients did not result in inferior fertilization rates or the occurrence of pregnancy. [3] These findings suggest that a female antisperm antibodies may not hinder fertilization in vitro. [4] This study questions the value of routine screening of female serum for antisperm antibodies in ART.