title: Antisperm antibodies are not associated with pregnancy rates after IVF and ICSI: systematic review and meta-analysis.
abstract: BACKGROUND
  Several studies have examined the relationship between direct antisperm antibody (ASA) levels in semen and pregnancy rate after advanced assisted reproductive technologies (ARTs) but the results have been inconsistent. The aim of our study was to further evaluate the relationship between ASA and pregnancy after IVF or ICSI by systematic review and meta-analysis.
  
  
  METHODS
  We conducted a systematic Medline search of all relevant full papers on direct semen ASA and pregnancy after IVF or ICSI. Three investigators independently reviewed the papers, followed by group discussion to choose the included papers. Meta-analysis was performed to get an odds ratio (OR) for the effect of ASA on pregnancy using IVF or ICSI.
  
  
  RESULTS
  The study identified and analyzed 16 valid studies (10 IVF and 6 ICSI). The study characteristics (including the ASA cutoff values) were heterogeneous. Our meta-analysis revealed that the combined OR for failure to achieve a pregnancy using IVF or ICSI in the presence of positive semen ASA was 1.22 (95% CI: 0.84, 1.77) and 1.00 (95% CI: 0.72, 1.38), respectively. The overall (IVF + ICSI) combined OR was 1.08 (95% CI: 0.85, 1.38).
  
  
  CONCLUSIONS
  This systematic review and meta-analysis indicate that semen antisperm antibodies are not related to pregnancy rates after IVF or ICSI, suggesting that both forms of ART remain viable options for infertile couples with semen ASA. However, additional, well-designed prospective studies using appropriate ASA cutoff levels are needed to further address this issue.
authors.affiliation: Division of Urology, Department of Surgery, McGill University, Montreal, QC, Canada. ziniarmand@yahoo.com
authors.forename: Armand
authors.initials: A
authors.lastname: Zini
authors.forename: Nader
authors.initials: N
authors.lastname: Fahmy
authors.forename: Eric
authors.initials: E
authors.lastname: Belzile
authors.forename: Antonio
authors.initials: A
authors.lastname: Ciampi
authors.forename: Naif
authors.initials: N
authors.lastname: Al-Hathal
authors.forename: Ahmed
authors.initials: A
authors.lastname: Kotb
mesh_terms: D000906:Antibodies / Q000032:analysis*; D005260:Female; D005307:Fertilization in Vitro; D006801:Humans; D008297:Male; D016017:Odds Ratio; D011247:Pregnancy; D018873:Pregnancy Rate; D012661:Semen / Q000276:immunology; D020554:Sperm Injections, Intracytoplasmic; D013094:Spermatozoa / Q000276:immunology*
chemical_list: D000906:Antibodies