Abnormal reactivity of spermatozoa with immunoglobulin: Case report of an infertile couple
Infertility because of the presence of sperm directed antibodies is well documented, and an increasing number of clinical laboratories now test for these immunoglobulins with the use of a variety of techniques. When antibodies are detected, many clinicians prescribe short-term corticosteroid treatment to suppress immunoglobulin production. Because the side effects of oral corticosteroid usage are not trivial, the accuracy and specificity of the sperm antibody determinations are of paramount importance. The nonimmune binding of immunoglobulin to human spermatozoa, and subsequent sperm agglutination, has been documented. Through the process of disulphide exchange, the Fc region of IgG, especially when combined with antigen, can nonspecifically attach to the sperm surface. Therefore, in sperm antibody determinations, the appropriate controls must always be included to rule out false-positives because of the presence of antigen-antibody complexes in the test serum and/or sperm surface abnormalities, especially in the male partner, which result in increased nonspecific IgG binding. In this communication, we report on an infertile couple in whom an apparent finding of sperm antibodies in the woman was, in reality, a case of sperm surface abnormality.