Journal of Reproduction & Infertility

Journal of Reproduction & Infertility

Effects of Varicocelectomy on Anti-sperm Antibody in patients with Varicocele

Authors
1 Drug Applied Research Center, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran; Department of Immunology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
2 Department of Urology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
3 School of Public Health and Nutrition, Tabriz University of Medical Sciences, Tabriz, Iran
Abstract
Background: Anti-sperm antibody (ASA) can decrease sperm motility and, therefore, it is a cause of male infertility. The aim of this study was to evaluate the effects of varicocelectomy on anti-sperm antibody in patients with varicocele. Methods: This observational study was conducted on 90 patients with varicocele at Sina and Imam Khomeini hospitals during 2006 to 2009. All varicocelectomy candidates were selected for ASA assessment both in semen and serum before and after surgery. ASA level was measured using a direct method for semen and an indirect method of Sperm MAR test, for serum. Paired t-test and McNemar's test were used for data analysis, and p < 0.05 was considered statistically significant. Results: ASA level in semen was 13.7% before, and 15.7% after three month of varicocelectomy (p=0.881). Serum level of ASA before and after surgery were 13.6% and 21.7%, respectively (p=0.033). Three parameters including sperm count, motility and morphology showed recovery following, varicocelectomy, but only the difference in sperm motility was significant (p < 0.05). Conclusion: This study showed that varicocelectomy has no effect on semen ASA. Although serum antibody has been shown to increase after varicocelectomy but sperm motility will improve. Varicocelectomy seems to have a beneficial effect on semen parameters in infertile men with varicocele.
Keywords

  1. Rogenio A, Lobo A, Daniel R, Richard JR, Pavlson M. Role of immunology in infertility. In: Lobo A, Mishell DR, Paulsen RJ, Shoupe D, editors. Infertility, contraception and reproductive endocrinology. Massachusetts: Blackwell Science; 1997. p. 675-9.
  2. Bronson RA, O'Connor WJ, Wilson TA, Bronson SK, Chasalow FI, Droesch K. Correlation between puberty and the development of autoimmunity to spermatozoa in men with cystic fibrosis. Fertil Steril. 1992;58(6):1199-204.
  3. Flickinger CJ, Baran ML, Howards SS, Herr JC. Sperm autoantigens recognized by autoantibodies in developing rats following prepubertal obstruction of the vas deferens. J Androl. 1996;17(4):433-42.
  4. De Almeida M, Soumah A, Jouannet P. Incidence of sperm-associated immunoglobulins in infertile men with suspected autoimmunity to sperm. Int J Androl. 1986;9(5):321-30.
  5. Heidenreich A, Bonfig R, Wilbert DM, Strohmaier WL, Engelmann UH. Risk factors for antisperm antibodies in infertile men. Am J Reprod Immunol. 1994;31(2):69-76.
  6. Sinisi AA, Di Finizio B, Pasquali D, Scurini C, D'Apuzzo A, Bellastella A. Prevalence of antisperm antibodies by SpermMARtest in subjects undergoing a routine sperm analysis for infertility. Int J Androl. 1993;16(5):311-4.
  7. Haas GG Jr, Lambert H, Stern JE, Manganiello P. Comparison of the direct radiolabeled antiglobulin assay and the direct immunobead binding test for detection of sperm-associated antibodies. Am J Reprod Immunol. 1990;22(3-4):130-2.
  8. Ohl DA, Naz RK. Infertility due to antisperm antibodies. Urology. 1995;46(4):591-602.
  9. Oshinsky GS, Rodriguez MV, Mellinger BC. Varicocele-related infertility is not associated with increased sperm-bound antibody. J Urol. 1993;150(3):871-3.
  10. Flickinger CJ, Howards SS, Bush LA, Baker LA, Herr JC. Antisperm autoantibody responses to vasectomy and vasovasostomy in Fischer and Lewis rats. J Reprod Immunol. 1995;28(2):137-57.
  11. Marc GO. Surgical management of male infertility and other scrotal disorders. In: Walsh PC, Retik AB, Vavghao ED, Wein AJ, editors. Campbell's Urology. Philadelphia: W.B. Saunders; 2002. p. 1571-7.
  12. Rajah SV, Parslow JM, Howell RJ, Hendry WF. Comparison of mixed antiglobulin reaction and direct immunobead test for detection of sperm-bound antibodies in subfertile males. Fertil Steril. 1992;57(6):1300-3.
  13. Almagor M, Margalioth EJ, Yaffe H. Density differences between spermatozoa with antisperm autoantibodies and spermatozoa covered with antisperm antibodies from serum. Hum Reprod. 1992;7(7):959-61.
  14. Cayan S, Kadioglu TC, Tefekli A, Kadioglu A, Tellaloglu S. Comparison of results and complications of high ligation surgery and microsurgical high inguinal varicocelectomy in the treatment of varicocele. Urology. 2000;55(5):750-4.
  15. Djaladat H, Mehrsai A, Rezazade M, Djaladat Y, Pourmand G. Varicocele and antisperm antibody: fact or fiction? South Med J. 2006;99(1):44-7.
  16. Ozen H, Asar G, Gungor S, Peker AF. Varicocele and antisperm antibodies. Int Urol Nephrol. 1985;17(1):97-101.
  17. Golomb J, Vardinon N, Homonnai ZT, Braf Z, Yust I. Demonstration of antispermatozoal antibodies in varicocele-related infertility with an enzyme-linked immunosorbent assay (ELISA). Fertil Steril. 1986;45(3):397-402.
  18. Knudson G, Ross L, Stuhldreher D, Houlihan D, Bruns E, Prins G. Prevalence of sperm bound antibodies in infertile men with varicocele: the effect of varicocele ligation on antibody levels and semen response. J Urol. 1994;151(5):1260-2.
  19. Gilbert BR, Witkin SS, Goldstein M. Correlation of sperm-bound immunoglobulins with impaired semen analysis in infertile men with varicoceles. Fertil Steril. 1989;52(3):469-73.
  20. Gubin DA, Dmochowski R, Kutteh WH. Multivariant analysis of men from infertile couples with and without antisperm antibodies. Am J Reprod Immunol. 1998;39(2):157-60.
  21. Liu RZ, Lu YL, Xu ZG, Zuo WJ, Xin JL, Wang ZS. [The effect of semen antisperm antibody on human sperm acrosin activity]. Zhonghua Nan Ke Xue. 2003;9(4):252-3. Chinese.
  22. Sinisi AA, D'Apuzzo A, Pasquali D, Venditto T, Esposito D, Pisano G, et al. Antisperm antibodies in prepubertal boys treated with chemotherapy for malignant or non-malignant diseases and in boys with genital tract abnormalities. Int J Androl. 1997;20(1):23-8.
  23. Stedronska J, Hendry WF. The value of the mixed antiglobulin reaction (MAR test) as an addition to routine seminal analysis in the evaluation of the subfertile couple. Am J Reprod Immunol. 1983;3(2):89-91.