Antisperm antibodies in infertile men and their effect on semen parameters: A systematic review and meta-analysis

Background: Antisperm antibodies (ASA) in males cause the autoimmune disease 'immune infertility'. The mechanism of ASA cause male infertility is not clear. Present studies have investigated the effect of ASA and their incidence in men with unexplained infertility, as well as to evaluate the correlation between the ASA and semen parameter alterations but have shown inconsistent results. We performed a systematic literature review and meta-analysis to assess the association between ASA and basic semen parameters in infertility men. Methods: Systematic literature searches were conducted with PubMed, EMBASE, Science Direct/Elsevier, CNKI and the Cochrane Library up to October 2014 for case-control studies that involved the impact of ASA on semen parameters. Meta-analysis was performed with Review Manager. Standard mean differences (SMD) of semen parameters were identified with 95% Cl in a random or fixed effects model. Results: Eight studies were identified, including 238 cases of ASA positive infertility male and 929 ASA negative controls. Our results illustrated that the sperm concentration and sperm motility (a+b) from ASA positive patients were significantly lower than ASA negative controls (SMD (95% Cl) -23.64 [-43.47, -3.81], -16.40 [-27.92, -4.88], respectively). However, semen liquefaction time in the ASA positive group was significantly longer than the control group (SMD (95% CI) 4.19 [1.72, 6.66]). There was no significant effect of ASA on the sperm volume, sperm viability, sperm progressive motility, sperm normal morphology and sperm abnormal morphology. Conclusions: The present study illustrates that there was a significant negative effect of ASA on sperm concentration, sperm motility (a+b) and sperm liquefaction. (C) 2015 Elsevier B.V. All rights reserved.