Immunological studies of testicular tissue in oligozoospermic and azoospermic patients

Testicular biopsies from 6 oligozoospermic and 12 azoospermic patients were examined histologically and immunohistologically. Evidence of maturation arrest and of Type II allergic reactions involving tubular basement membranes was found in all oligozoospermic patients. No evidence of an immune reaction was found in 9 azoospermic patients with maturation arrest. Unilateral or bilateral germ cell aplasia with evidence of mixed Type II and III or Type III and IV reactions was present in 2 oligozoospermic and 2 azoospermic patients. The findings have been interpreted to indicate that maturation arrest and germ cell aplasia may occasionally be linked in a chain of immunological events, initiated possibly by damage to tubular basement membranes. No correlation was demonstrable between the histological and immunohistological findings and indirect immunofluorescent tests for sperm antibodies. It is suggested that testicular biopsy is a potentially hazardous procedure in the investigation of infertility, and that prepubertal testicular tissues as well as sperm be used as antigens in the immunological investigation of infertility.

C1q precipitins in human seminal plasma

Seminal plasma was tested against purified C1q by double diffusion. Precipitation reactions were frequently observed in the seminal plasma of patients with normozoospermia and patients with azoospermia; most of these reactions were not due to soluble immune complexes binding to C1q. A factor resistant to DNAse and RNAse (mol wt: 25,000--150,000 daltons) was found to precipitate C1q. Its discovery adds to the list of substances which may interfere in C1q precipitation tests.

Immunologic studies of male infertility

Infertile men with azo- or oligospermia of unknown cause were investigated for evidence of testicular autoimmunity. Testicular germinal cell antibodies were found in 14% of the patients, compared with 5% of normal men, and 21% had spermatozoal antibodies, compared with 5% of the normal subjects. One-third had positive macrophage inhibitory factor tests, compared with 5% of normal subjects. However, of autoantibodies against thyroid, stomach, and nuclear material, only the prevalence of thyroid cytoplasmic antibodies was significantly greater than in normal subjects; serum IgG, IgM, and IgA levels were normal in all cases tested. Furthermore, there was no excess of lymphoid tissue on biopsy and no evidence of antibody deposition in the testicular tissue. The evidence for autoimmunity is less impressive than that for leprous orchitis, which has been proposed as a model for testicular organ-specific autoimmunity. Nevertheless, it is possible that certain germinal cell or spermatozoal antibodies may be directed against factors necessary for orderly spermatogenesis. If so, they may play a role in some cases of maturation arrest and shedding defects.