Spermagglutinating antibodies and sperm penetration of cervical mucus from infertile women with spermagglutinating antibodies in serum

Prognostic value of in vitro sperm penetration into hormonally standardized human cervical mucus

To analyze the prognostic value of the sperm cervical mucus penetration test (SCMPT), fresh semen samples of 99 male patients under infertility investigation were exposed to capillary tubes filled with freshly obtained cervical mucus (CM) of the patients' wives (WCM), fertile donors (DCM), and bovine CM (BCM). The quality of the human CM was standardized by oral administration of estrogens. The overall pregnancy rate after 6 months was 17.2% (17/99), and was significantly different in couples with poor and good SCMPT with WCM (1/44, 2.3% versus 16/55, 29%; P less than 0.001) in a prospective study. Human CM was superior to BCM as a penetration medium in providing more information about sperm function. The results suggest that in vitro sperm penetration testing with hormonally standardized CM of female partners adds an important dimension to sperm analysis with regard to fertility prognosis.

Variances in mucus architecture as a cause of cervical factor infertility

A cervical factor accounts for 5% to 10% of infertility among women. In the absence of an immunologic or endocrine-related basis for incompetent sperm/mucus interaction, an idiopathic cause is usually ascribed. This study describes quantitative analyses of the microstructure of mucin strands, observed under scanning electron microscopy, from infertile women displaying incompetent sperm/mucus interaction unrelated to any apparent immunologic or endocrine-associated cause. The results revealed a highly significant reduction in the spacing of mucin fibers incompatible to sperm penetrability and migration. Additional quantitative measurements of mucin strand diameter and number and geometry of strand crosslinks suggest inadequate hydration of the mucin gel as a causative basis for the structural inadequacies observed in some cases of cervical-factor infertility.

Detection of antispermatozoal antibodies of IgA class in cervical mucus

A simple procedure for detection of antisperm antibodies of IgA class in human cervical mucus is described and the results of its application to samples from 102 patients are presented. The results suggest that the IgA immunobead test (IgA-IBT) is a specific and clinically useful test for sperm antibodies. There was a strong correlation between the IgA-IBT and the presence of complement-dependent sperm immobilization in serum (Spearman's, r = 0.92, p less than 0.001). Positive IgA-IBT results occurred only in mucus samples that showed poor penetration by normal sperm. An added advantage of the IgA-IBT is that both the immunoglobulin class and the site of binding to the sperm surface can be determined simultaneously.

Are sperm immobilizing antibodies in cervical mucus an explanation for a poor postcoital test?

Previous authors reported high incidences of complement dependent sperm immobilizing antibodies in cervical mucus (CM) and found a correlation with poor postcoital tests. In all those investigations the CM samples were tested after dilution with a salt solution. In the present study we investigated 50 CM samples from infertile couples who had during the routine fertility investigation poor postcoital tests. All CM samples were tested after dilution with an equal volume of normal human serum; only one sample was found positive. On the other hand, if the CM samples were diluted with an equal volume of a buffered salt solution, many positive results were obtained. With some guinea pig serum batches, however, all tests with buffer-diluted CM samples were negative, despite good reaction of the positive control serum. We concluded that the positive results with buffer-diluted CM samples were due to a factor in the animal serum used as complement preparation and that complement-dependent sperm immobilizing antibodies in CM are an unlikely cause of a poor postcoital test.

Immunoglobulin class of sperm antibodies in cervical mucus from infertile women

By immunoaffinity chromatography using anti-IgG, anti-IgM, and anti-IgA coupled to CNBr-activated sepharose 4B, the immunoglobulin class of sperm-agglutinating antibodies was investigated in cervical mucus from four infertile women. In all patients, it was found that the sperm antibodies in cervical mucus belonged to the IgA class, whereas in serum, which was studied in two of the patients, IgG sperm antibodies were demonstrated. Absorption of the four cervical mucus samples with anti-secretory component sepharose 4B revealed that the IgA antibodies in at least two of the samples were SC-IgA antibodies. Investigation of a third sample by sucrose gradient ultracentrifugation revealed that the IgA sperm antibodies were characterized by a sedimentation coefficient between 9S and 13S, strongly suggesting the presence of SC-IgA antibodies. Accordingly, the sperm-agglutinating antibodies were SC-IgA antibodies in at least three of the four samples studied.

A comparison of eight techniques for the evaluation of the auto-immune response to spermatozoa after vasectomy

The tray agglutination tests (TAT), gelatin agglutination test (GAT), side agglutination test (SAT), tube-slide agglutination test (TSAT), sperm immobilization test (SIT), ATP-release cytotoxicity test (ARCT), indirect immunofluorescence technique (IFT) on methanol-fixed, intact spermatozoa, and a lymphocyte transformation test (LTT) were compared using a maximum of 329 blood samples taken from 47 men before and after vasectomy. The TAT, GAT, TSAT, SIT and ARCT discriminated between the pre- and post-vasectomy samples, and the sensitivity for sperm antibodies decreased in that order. The activity in the IFT and the LTT did not change significantly after vasectomy. In the TAT the mode of agglutination varied with serum dilution; the results for the 1:4 dilution showed the best agreement with the SAT results. Almost all TAT activity was detected by a combination of GAT and TSAT. Sperm agglutinins were present in all serum samples positive in the two complement-dependent tests, SIT and ARCT. If improved in sensitivity, the ARCT, which lacks the subjective elements of microscopy, might be suitable for the screening of male sera in clinical work. For the present, we recommend the TAT.