Influence of antisperm antibodies in the semen on in vitro fertlization with intracitoplasmic sperm injection (ICSI) outcomes.

[P-588] INFLUENCE OF ANTISPERM ANTIBODIES IN THE SEMEN ON IN VITRO FERTILIZATION WITH INTRACITOPLASMIC SPERM INJECTION (ICSI) OUTCOMES.

D. Telles Schneider, S. Verza Jr., S. C. Esteves. ANDROFERT-Centro de Referência em Infertilidade Masculina, Campinas, Brazil

Objective: Antisperm antibodies (ASA) can impair sperm motility by agglutination or immobilization, thus decreasing sperm migration through the female genital tract. ASA can also alter the mechanisms of capacitation and acrosome reaction, which may impair the sperm-oolema interaction. The aim of this study was to analyze the influence of autoantibodies against spermatozoa present in the semen on the outcome of in vitro fertilization with intracytoplasmic sperm injection (ICSI).

Design: Retrospective analysis of clinical and laboratorial data from 351 ICSI cycles.

Materials and Methods: The ICSI cycles were performed from January 2000 to November 2005. Evaluation of immunological male infertility was accomplished previously during routine semen analysis by using the direct immunobeads test (IBT). According to the percentage of antibody-bound spermatozoa in semen, we grouped the ICSI cycles into four groups: group I (n=194): 0% to 10% ASA; group II (n=107): 11% to 20%; group III (n=33): 21% to 50% and group IV (n=17): 51 a 100%. ASA values were considered within the normal range in groups I and II, whereas ASA values in groups III and IV were considered elevated. Sperm washing for ICSI was performed by using discontinuous two-layer density gradient. ICSI outcome for analysis included fertilization rate (2PN), cleavage rate, cleavage velocity, embryo quality, clinical pregnancy rate and miscarriage rate. Comparisons among groups were performed by using Kruskal-Wallis ANOVA, Mann-Whitney rank-sum test and Chi-square as appropriate, with an alpha level of 5% considered significant.

Results: Fertilization and cleavage rates, cleavage velocity, percentage of good quality embryos, as well as clinical pregnancy and miscarriage rates did not differ statistically among groups. In addition, when normal (groups I+II) and elevated ASA (groups III+IV) groups were compared, the fertilization, cleavage, good quality embryos, clinical pregnancy and miscarriage rate after ICSI were 77.7 and 80.0%, 100.0 and 100.0%, 50.0% and 50.0%, 53.2% and 51.5%, 17.9 and 23.5%, respectively, and the differences between both groups were found to be not significant.

Conclusion: Our data suggest that the presence of antisperm antibodies in the semen have no negative impact on intracytoplasmic sperm injection outcome. ICSI appears to be efficient to treat immunological male infertility, and it can offer similar success rates for men with significant ASA seminal levels as compared to men submitted to ICSI for other reasons.