Cytotoxic antibodies to lymphocytes: relationship to sperm immunity

A comparison of sperm antibody assays

Cytotoxicity and Immunobead-binding immunoglobulin G assays agreed in 81% of sera from infertile men (n = 173), 74% of sera from their wives, 75% of seminal plasma, and 82% of cervical mucous samples (p less than 0.001; chi 2 analysis of positive and negative results) when tested against sperm from the same donors. Cytotoxic and immunofluorescent IgG antibody results agreed in 79% of sera from men and women, 76% of seminal plasma, and 76% of cervical mucus (p less than 0.001; chi 2 analysis of positive and negative results). Titers or percent binding of sperm by cytotoxicity, hemagglutination, and IgG Immunobead-binding or immunofluorescence assays in serum and secretions of husbands and wives correlated (p less than 0.001). A significantly increased number of positive results was observed in cytotoxic and Immunobead-binding IgG assays when the husbands' and donors' sperm were used rather than donors' sperm alone. On the basis of this study we conclude: (1) that cytotoxicity, Immunobead-binding IgG, and immunofluorescent IgG sperm antibody assays correlate when sperm from the same source are used, (2) that women's isoimmunity to husbands' sperm is associated with their husbands' autoimmunity to sperm irrespective of the assay, and (3) that it is desirable to use sperm from the husbands and nonautoimmune fertile men in these assays.

White cell subpopulations in autoimmune infertile men and their wives with cytotoxic sperm antibodies

Sixty six infertile men with cytotoxic sperm antibodies had fewer and lower percentages of OKT4-positive helper/inducer T lymphocytes p = 0.004 and 0.003, respectively), than the fertile (n = 14) and infertile (n = 12) antibody-negative controls. Ratio of OKT4/OKT8 was decreased (p less than 0.01), while numbers of OKDR and BD-Leu12 positive predominantly B lymphocytes were increased (p less than 0.0001) in infertile men with sperm antibodies. T lymphocytes positive for OKT3, OKT11 and OKT4 and the OKT4/OKT8 ratio were decreased in infertile women with sperm antibodies, while B lymphocytes positive for OKDR and BD-Leu12 were increased in infertile women with or without sperm antibodies (p less than 0.0001, versus fertile controls). Lymphocyte responses to phytohemagglutinin (PHA), concanavalin A (ConA) and pokeweed mitogen (PWM), however, were similar in 20 fertile and 136 infertile couples. Lymphocytes from infertile men with sperm antibodies had an enhanced stimulatory response to autologous sperm and seminal plasma. It is concluded that sperm antigens from autoimmune infertile men stimulate heightened immune responses to sperm antigens and altered distribution of white cell populations in both partners.

A computerized postcoital test sperm motility: comparison with clinical postcoital test and correlations with sperm antibodies

Sixty-five infertile women had a conventional postcoital test (PCT), a computerized postcoital test (cPCT), and sperm antibody testing. Twenty-four women had good cervical mucus and good PCT sperm motility (group 1), 23 had poor cervical mucus and poor PCT sperm motility (group 2), and 18 had good cervical mucus but poor PCT sperm motility (group 3). The percentage of motile sperm, mean linearity, and the motility index of sperm by cPCT also were decreased in groups 2 and 3 (p less than 0.001) in contrast to group 1. A reduced PCT sperm count was significantly associated with positive titers of antibodies to autologous sperm in the husbands' serum, whereas a reduced PCT motility correlated with high titers of cytotoxic antibodies to husbands' sperm in the wives' serum and cervical mucus. An increased percentage of vibratory sperm at PCT correlated with elevated titers of cytotoxic antibodies to husbands' sperm in the wives' serum and cervical mucus, and hemagglutinating (r = 0.44; p less than 0.001) and immunofluorescent IgA antibodies to husbands' sperm (r = 0.47; p less than 0.001) in the cervical mucus. Mean swimming speed of sperm by cPCT correlated inversely with cytotoxic and hemagglutinating antibody titers to husbands' sperm, and immunobead-binding IgM and immunofluorescent IgG, IgA, and IgM (r = 0.52; p less than 0.001) antibodies to sperm in the seminal plasma. Motility indices correlated inversely with cytotoxic antibody titers to husbands' sperm in the wives' serum, and hemagglutinating antibody titers to husbands' sperm in cervical mucus. The predictive values of PCT and cPCT for the presence of cytotoxic and immunofluorescent IgA antibodies to autoimmune husbands' sperm were 76% and 71%, respectively, in the serum and 85% and 75%, respectively, in the cervical mucus of the wives. The predictive value of PCT and cPCT for immunobead-binding and immunofluorescent IgM antibodies to sperm in the wives' serum was 71%. Computerized PCT measures more sperm characteristics than PCT, although it is in general agreement with PCT.

Antibodies to microbial, leukocyte and organ antigens

Hemagglutinating antibodies to Mycoplasma hominis were present in 30 of 83 infertile, 15 of 40 pregnant and 5 of 20 post-partum females and 20 of 82 infertile males in contrast to only 2 of 21 fertile females and 5 of 25 fertile males. Their presence correlated with sperm antibody detection by TAT in Lab. 4, the immunobead-binding assay of Lab. 1 and the SIT of Lab. 11, but not with other sperm antibody assays. Immunofluorescent antibodies to Chlamydia trachomatis, on the other hand, did not correlate with the incidence of sperm antibodies. Among 305 serum samples tested, 12 were positive for testicular antibodies, 8 had antibodies to kidney, 7 to ovary and 15 to endometrium. A majority of serum samples positive for antibodies to testis and ovary, but not endometrium, reacted against sperm in different assays. Eight of 135 samples tested had antibodies to human leukocyte antigenic HLA-Aw19 (Aw19, A28, A29, A30 and A32) and/or B35 (B35, B5 and B15) complexes. Six of these samples were also positive for sperm antibodies by one or more antibody assays. Cross-reactive antigens may be present in sperm, M. hominis, testis, ovary and leukocytes.

Females' isoimmunity to sperm is associated with sperm autoimmunity in their husbands

One hundred twenty-five fertile couples and 334 infertile couples were tested for the presence of cytotoxic and hemagglutinating antibodies to sperm. Elevated titers of sperm antibodies were absent in both partners of fertile couples. Of 79 infertile males with levels of sperm antibodies in the previously established negative range, 97% had wives who also had low titers of sperm antibodies. Of 255 infertile males positive for serum hemagglutinating antibodies, 56% had wives whose serum contained significant circulating hemagglutinating antibodies, while 93 of 202 (46%) males with significant cytotoxic antibody titers had wives whose serum contained elevated cytotoxic antibody titers. The females developed elevated titers of sperm antibodies in the serum and cervical mucus if their husbands had significant titers of hemagglutinating and cytotoxic sperm antibodies in the serum and seminal plasma samples. Females' isoimmunity to sperm was significantly associated with their husbands' autoimmunity to sperm and infertility.