The effect of female antisperm antibodies on in vitro fertilization, early embryonic development, and pregnancy outcome.
OBJECTIVE
To evaluate the extent to which human in vitro fertilization-embryo transfer (IVF-ET) alleviates immunological infertility.


METHODS
Retrospective.


METHODS
In vitro fertilization program.


METHODS
Thirty-three patients with positive antisperm antibodies undergoing 50 cycles of IVF-ET in which maternal serum was replaced by 5 mg/mL of bovine serum albumin (BSA) comprised the study group. Seventy-one patients with tubal infertility served as controls. In 50 of these, medium was supplemented with 7.5% maternal serum, and 21 were assigned to BSA substitution.


RESULTS
Percentage of fertilization in the study group was significantly lower (41 +/- 31; mean +/- SD) than that of controls with maternal serum (77 +/- 15) and BSA (76 +/- 22). Early embryonic quality, as assessed by percentage of cleavage and morphological grading, was found to be inferior in patients with antisperm antibodies. The percentage of advanced embryos (greater than or equal to 4 blastomeres) at the time of transfer was 42 +/- 39 in the study group, compared with 65 +/- 23 and 75 +/- 35 for maternal serum and BSA controls, respectively. Percentage of morphologically favorable embryos (grades 1 and 2 in a 1 to 5 grading system) was 49 +/- 31 in the study group, compared with 78 +/- 35 and 74 +/- 23 for the controls. Percentage of clinical pregnancy was somewhat lower in the study group (12.5%) than in controls with either maternal serum (18%) or BSA (19%).


CONCLUSIONS
Antisperm antibodies may have an adverse effect on fertilization and early embryonic development. Female immunological infertility may not be completely alleviated by IVF-ET.
Vazquez-Levin
M
M
Department of Obstetrics, Gynecology, and Reproductive Science, Mount Sinai Medical Center, New York City, New York.
Kaplan
P
P
Guzman
I
I
Grunfeld
L
L
Garrisi
G J
GJ
Navot
D
D
D000328:Adult; D000906:Antibodies / Q000276:immunology*; D002970:Cleavage Stage, Ovum; D004624:Embryo Transfer; D004622:Embryo, Mammalian / Q000502:physiology*; D005260:Female; D005307:Fertilization in Vitro; D006801:Humans; D007247:Infertility, Female / Q000276:immunology* / Q000628:therapy; D008297:Male; D011247:Pregnancy; D011256:Pregnancy Outcome; D013094:Spermatozoa / Q000276:immunology*
D000906:Antibodies