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Anti-sperm antibodies detection by a modified MAR test: Towards a better definition of its indications

  • Nicolas Gatimel
    Correspondence
    Corresponding author.
    Affiliations
    Service de Médecine de la Reproduction, Hôpital Paule de Viguier, CHU Toulouse, 330 avenue de Grande Bretagne, Toulouse 31059, France

    Université Paul Sabatier Toulouse-III, Groupe de Recherche en Fertilité Humaine (EA 31694, Human Fertility Research Group), 330 avenue de Grande Bretagne, Toulouse 31059, France
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  • Jessika Moreau
    Affiliations
    Service de Médecine de la Reproduction, Hôpital Paule de Viguier, CHU Toulouse, 330 avenue de Grande Bretagne, Toulouse 31059, France

    Université Paul Sabatier Toulouse-III, Groupe de Recherche en Fertilité Humaine (EA 31694, Human Fertility Research Group), 330 avenue de Grande Bretagne, Toulouse 31059, France
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  • François Isus
    Affiliations
    Service de Médecine de la Reproduction, Hôpital Paule de Viguier, CHU Toulouse, 330 avenue de Grande Bretagne, Toulouse 31059, France

    Université Paul Sabatier Toulouse-III, Groupe de Recherche en Fertilité Humaine (EA 31694, Human Fertility Research Group), 330 avenue de Grande Bretagne, Toulouse 31059, France
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  • Nathalie Moinard
    Affiliations
    Service de Médecine de la Reproduction, Hôpital Paule de Viguier, CHU Toulouse, 330 avenue de Grande Bretagne, Toulouse 31059, France

    Université Paul Sabatier Toulouse-III, Groupe de Recherche en Fertilité Humaine (EA 31694, Human Fertility Research Group), 330 avenue de Grande Bretagne, Toulouse 31059, France
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  • Jean Parinaud
    Affiliations
    Service de Médecine de la Reproduction, Hôpital Paule de Viguier, CHU Toulouse, 330 avenue de Grande Bretagne, Toulouse 31059, France

    Université Paul Sabatier Toulouse-III, Groupe de Recherche en Fertilité Humaine (EA 31694, Human Fertility Research Group), 330 avenue de Grande Bretagne, Toulouse 31059, France
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  • Roger D. Leandri
    Affiliations
    Service de Médecine de la Reproduction, Hôpital Paule de Viguier, CHU Toulouse, 330 avenue de Grande Bretagne, Toulouse 31059, France

    Université Paul Sabatier Toulouse-III, Groupe de Recherche en Fertilité Humaine (EA 31694, Human Fertility Research Group), 330 avenue de Grande Bretagne, Toulouse 31059, France
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Published:October 22, 2018DOI:https://doi.org/10.1016/j.rbmo.2018.09.011

      Abstract

      Research question

      Anti-sperm antibodies (ASA) have been shown to reduce male fertility but consensus about the precise situations in which tests should be carried out are lacking. In infertility investigations, should the mixed antiglobulin reaction (MAR) test be a first-line test? Should it be carried out systematically before assisted reproductive technology (ART)? What are the risk factors for ASA?

      Design

      All infertile patients (n = 1364) were tested with SpermMar (modified MAR test) between July 2013 and June 2017. Intra-patient variability of the MAR test was also assesed by comparing two tests within the same year in selected patients (n = 101).

      Results

      The main factor that influenced the percentage of ASA was the presence or absence of sperm agglutination. In the presence of agglutinations, 27 out of 72 (37.5%) patients were positive for ASA compared with 33 out of 1292 (2.6%) in the absence of agglutinations (P < 0.0001). When one risk factor was present (spontaneous sperm agglutination, history of scrotal trauma or inguinal surgery), 33 out of 179 (18.44%) tests were positive for ASA (≥50% coated spermatozoa), whereas only 27 out of 1242 (2.2%) were positive when no risk factor was present (P < 0.0001).

      Conclusions

      ASA detection should not be systematically recommended in investigations of fertility status and before ART but reserved for when sperm agglutination is found during conventional sperm examination, or if the patient has a history of scrotal trauma or has undergone inguinal surgery.

      KEY WORDS

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      Biography

      Nicolas Gatimel has been working as an embryologist at CHU Toulouse’s assisted reproduction unit since 2011. He obtained a specialist degree in medical biology after a 4-year residency in medical biology, specializing in assisted reproductive technologies. His PhD thesis was on the interest of human sperm morphology assessment.
      Key message
      Anti-sperm antibodies detection should not be systematically recommended in investigations of fertility status and before assisted reproductive technology treatment, but reserved for when sperm agglutination is found during conventional sperm examination or if the patient has a history of scrotal trauma or of inguinal surgery.