Objective: To investigate the impact of immunoglobulin (Ig) isotypes and their location on the human sperm surface on fertilization in vitro.
Design: Restrospective review and analysis.
Setting: Reproductive endocrine division of a level 3 academic center.
Patients: Forty-eight couples (80 IVF cycles) with males showing positive antisperm antibodies on the sperm surface by immunobead test, treated by IVF at the Norfolk Program.
Main Outcome Measure: Evaluation of total fertilization rate of preovulatory oocytes (metaphase II-metaphase I).
Results: Immunoglobulin G and IgA antibody levels have no significant correlation with total fertilization rate of preovulatory oocytes by logistic regression. Immunoglobulin M, present in 44% of the couples, had a strong correlation with fertilization. When IgA showed very high levels of binding (> 68%) and IgM binding was > 40%, the fertilization rate dropped significantly. A strong correlation between presence of antibodies and fertilization rate was seen when IgM was directed to the head or tail tip of the sperm. Immunoglobulin A induced a statistically significant reduction of fertilization only when it was present on the head.
Conclusion: Two male antisperm Ig isotypes significantly impaired fertilization rates. Immunoglobulin A exerted its impact only when high level of binding was detected on the head. Immunoglobulin M, present in 44% of the males, was the Ig isotype that most significantly affected fertilization rates when localized both at the head and at the tail tip level.
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