Varicocele and antisperm antibody: fact or fiction?
OBJECTIVE
To study the level of antisperm antibodies (ASAB) in the serum and semen of infertile men with varicocele before and 6 months after varicocelectomy.


METHODS
We performed a prospective study of 81 infertile men undergoing microsurgical inguinal varicocelectomy. Female factor was excluded. Semen analysis and seminal and serum ASAB (direct and indirect IgG and IgA), as measured by SpermMar test, were performed before and after surgery at 6 months. A control group consisting of idiopathic infertile patients was evaluated for ASAB.


RESULTS
Eighty-one patients with a mean age of 28.7 years (23 to 42) completed our study. Mean sperm count, motility, and abnormal forms were improved after surgery and were statistically significant for sperm density and morphology (P < 0.05). Before surgery, 21 patients (26%) had a low positivity for ASAB (10 to 40%). Six months after surgery, the ASAB titer was reduced in 15 (A group), increased in 3 (B group), and reduced in another 3 (C group). The C group also had an increase in other titers. In the A group sperm count, motility and normal forms improved after surgery (P < 0.05). In the B group, motility was reduced after surgery. In the C group, motility and normal forms were reduced after surgery. Sixty patients were negative for ASAB before surgery. Of these, 48 showed an increase in at least one of the ASAB types to some degree that had no significant effect on semen parameters. In the control group, two patients (7%) were weakly positive for ASAB.


CONCLUSIONS
Varicocelectomy may reduce the ASAB level, and this reduction has a good effect on semen parameter quality. Also, it may raise the ASAB level in some patients. This positive conversion has no adverse effect on semen parameters.
Djaladat
Hooman
H
Department of Urology, Mohammadi Hospital, Hormozgan University of Medical Sciences, Tehran, Iran. hoomanj@yahoo.com
Mehrsai
Abdolrasol
A
Rezazade
Modjtaba
M
Djaladat
Yasaman
Y
Pourmand
Gholamreza
G
D000328:Adult; D000888:Antibodies, Anti-Idiotypic / Q000276:immunology*; D015415:Biomarkers / Q000378:metabolism; D005500:Follow-Up Studies; D006801:Humans; D007070:Immunoglobulin A / Q000276:immunology*; D007074:Immunoglobulin G / Q000276:immunology*; D007248:Infertility, Male / Q000209:etiology / Q000276:immunology / Q000517:prevention & control; D008297:Male; D011379:Prognosis; D011446:Prospective Studies; D013094:Spermatozoa / Q000276:immunology*; D013521:Urologic Surgical Procedures, Male / Q000379:methods; D014646:Varicocele / Q000150:complications / Q000276:immunology* / Q000601:surgery
D000888:Antibodies, Anti-Idiotypic; D015415:Biomarkers; D007070:Immunoglobulin A; D007074:Immunoglobulin G