Anti-sperm Antibody Positivity in Men with Varicocele: A Systematic Review and Meta-Analysis

被引:3
作者
Falcone, Marco [1 ,2 ]
Bocu, Kadir [2 ,3 ]
Keskin, Hakan [2 ,4 ]
Vazquez, Jesus Fernando Solorzano [2 ,5 ]
Banthia, Ravi [2 ,6 ]
Mahendran, Tara [2 ,7 ]
Deger, Muslim Dogan [2 ,8 ]
Kv, Vinod [2 ,9 ]
Mirko, Preto [2 ,9 ]
Harraz, Ahmed M. [2 ,10 ,11 ,12 ]
Saleh, Ramadan [2 ,13 ,14 ]
Shah, Rupin [2 ,15 ]
Agarwal, Ashok [2 ,16 ]
机构
[1] Univ Turin, Molinette Hosp, Dept Urol, Azienda Osped Univ Citt Salute & Sci Torino, Turin, Italy
[2] Global Androl Forum, 130 West Juniper Lane, Moreland Hills, OH 44022 USA
[3] Silopi State Hosp, Dept Urol, Sirnak, Turkiye
[4] Hacettepe Univ, Sch Med, Dept Urol, Ankara, Turkiye
[5] CITMER Reprod Med, Mexico City, Mexico
[6] Western Gen Hosp, Dept Urol, Edinburgh, Scotland
[7] Androl Ctr, Coimbatore, India
[8] Edirne Sultan 1st Murat State Hosp, Dept Urol, Edirne, Turkiye
[9] Univ Turin, Molinette Hosp AOU Citt Salute & Sci Torino, Dept Urol, Turin, Italy
[10] Sabah Al Ahmad Urol Ctr, Kuwait, Kuwait
[11] Farwaniya Hosp, Gen Surg Dept, Urol Unit, Farwaniya, Kuwait
[12] Mansoura Univ, Dept Urol, Urol & Nephrol Ctr, Mansoura, Egypt
[13] Sohag Univ, Fac Med, Dept Dermatol Venereol & Androl, Sohag, Egypt
[14] Ajyal Hosp, Ajyal IVF Ctr, Sohag, Egypt
[15] Lilavati Hosp & Res Ctr, Dept Urol, Div Androl, Mumbai, India
[16] Cleveland Clin Fdn, Cleveland, OH USA
关键词
Antisperm antibodies; Enzyme-linked immunosorbent assay; Immunoglobulins; Infertility; Varicocele; SEMEN PARAMETERS; SPERM ANTIGENS; INFERTILE MEN; PATHOGENESIS; ASSOCIATION; FERTILITY; DIAGNOSIS;
D O I
10.5534/wjmh.240003
中图分类号
R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
摘要
Purpose: Despite the significant role of varicocele in the pathogenesis of male infertility, its association with anti-sperm antibodies (ASA) remains controversial. This systematic review and meta-analysis (SRMA) aims to investigate the frequency of ASA positivity in men with varicocele. Materials and Methods: This SRMA is conducted in accordance with the Meta-analysis of Observational Studies in Epidemiology guidelines. We investigated the frequency of ASA positivity in ejaculates or serum of men with varicocele as compared to men without varicocele (controls). A literature search was performed using the Scopus and PubMed databases following the Population Exposure Comparison Outcome, Study Design model. Data extracted from eligible studies were meta-analyzed and expressed as odds ratios (ORs) and confidence intervals (CIs). Results: Out of 151 abstracts identified during the initial screening, 6 articles met the inclusion criteria and were included in the meta-analysis. Using mixed antiglobulin reaction (MAR) assay, 61 out of the 153 (39.8%) patients with varicocele tested positive for ASA in their ejaculates as compared to 22 out of the 129 control subjects (17%, OR=4.34 [95% CI: 1.09-17.281; p=0.04). Using direct or indirect immunobead test, 30 out of 60 cases diagnosed with varicocele (50%) had shown ASA positivity in their ejaculates as compared to 16 out of 104 controls (15.4%, OR=3.57 [95% CI: 0.81-15.681; p=0.09). Using enzyme-linked immunosorbent assay (ELISA), out of 89 varicocele patients, 33 (37.1%) tested positive for serum ASA as compared to 9 out of 57 participants in the control group (15.8%, OR=7.87 [95% CI: 2.39-25.891; p<0.01). Conclusions: This SRMA indicates that ASA positivity is significantly higher among men with varicocele when tested by direct method (MAR) or indirect method (ELISA). This data suggests an immunological pathology in infertile men with varicocele and may have implications for the management of these patients.
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