Treatment of infertile couples by intrauterine artificial insemination homologous (AIH) of motile sperm collected by swim-up in human serum.

Twenty six couples with long standing infertility were treated by intrauterine AIH. Seminal and/or cervical factors were responsible for negative or poor coital test (PCT); retrograde ejaculation occurred in one case. A highly concentrated motile sperm suspension was obtained by swim-up procedure into fasting human serum and utilized for intrauterine insemination. Timing of ovulation was checked with the aid of ultrasound monitoring of follicular development. Totally, 120 cycles were treated. The pregnancy rate was 23.3%. Intrauterine AIH with motile sperm recovered by swim-up in human serum appears a valuable approach in the treatment of infertile couples with poor PCT as well as in cases of retrograde ejaculation.

Detection of sperm surface related antibodies by indirect immunofluorescence test on sperm suspensions. Indirect IFT on sperm suspensions.

An indirect immunofluorescence test (IIFT) using sperm suspensions was carried out on 20 sera with sperm agglutinins (SA) and on 25 negative controls. IIFT gave results highly correlated with the occurrence of sperm agglutinating activity. Moreover, a relation was found among class of Ig involved in IF reactivity, fluorescent stain pattern and type of sperm agglutinations. In all sera with "mixed" or "tail-tail" sperm agglutinating activity, IgG were involved in IF reactivity; the fluorescent stain constantly appeared in a granular pattern along the sperm tail and most often on the head surface too. In relation to high titres of "head-head" sperm agglutinating activity, IgM were involved in IF reactivity; here the fluorescent stain appeared to be localized on acrosomal surface. The results indicate that indirect IFT on sperm suspensions specifically detects sperm surface related antibodies.

Modification of the slide agglutination test for the detection of sperm-agglutinins.

We have modified the slide agglutination test (SAT) in order to make it available for the routine detection and titration of sperm agglutinins. Serum and seminal plasma samples of 156 subfertile patients were tested by the modified slide agglutination test (MSAT) in two trials. Fifteen per cent of serum and 7.5% of siminal plasma samples gave positive results and MSAT showed excellent reproducibility: a highly significant statistical correlation between the positive titres in the two determinations was observed. One hundred and ten samples were tested simultaneously by the MSAT and the tray agglutination test (TAT). The two tests showed a similar sensitivity with a significant statistical correlation between the positive titres. Using the MSAT the reading of results was easier and more precise. Therefore we propose the MSAT for the routine detection and titration of sperm-agglutinins.

Immunological screening of a male population with infertile marriages.

Four hundred not preselected male partners of infertile marriages were screened for the presence of anti-sperm antibodies. Serum and seminal plasma specimens from each patient were tested by the modified slide agglutination test (MSAT) and by the sperm-immobilization test. In addition, the IgG MAR test was performed on fresh ejaculates. Thirteen per cent of patients showed sperm agglutinating activity in serum and 5.7% also in seminal plasma. Sperm-immobilizing activity was found in 4.7% of serum and 1% of seminal plasma specimens, always associated with a high titre of sperm agglutinating activity. A highly significant linear correlation was found between the results of the MAR test and serum sperm-agglutinating activity; the presence of sperm-agglutinating activity in seminal plasma was always associated with MAR test positivity greater than 50%. The incidence of anti-sperm antibodies was not significantly different in patients with normo-, oligo- and azoospermia. The effectiveness and the easiness of both the MAR test and the MSAT do not justify, in our opinion, the utilization of more complex and expensive techniques for the detection of anti-sperm antibodies.