[Sperm agglutination antibodies studied in infertile couples at the Women's Clinic in Plzen 1980-1988]. / Spermaglutinacní protilátky vysetrované u neplodných páru na zenské klinice v Plzni v období 1980-1988.

The authors assessed sperm-agglutination antibodies in infertile couples in 1980-1988, using the Kibrick test: in sera from 699 female patients, a positive result was found in 142 (20%) women, in sera from 352 men, in 6 (1.7%) sperm-agglutination antibodies were detected. Using the microagglutination test, they examined sera of 3501 sterile women; in 273 (6.8%) they found sperm agglutination up to 1:16, above titre 1:32 in 12 (0.4%) of the patients. Using the same test, they examined sera of 2803 men and found sperm-agglutination up to 1:16 in 21 (0.7%) and above 1:32 in 6 (0.3%). The most frequent type of sperm agglutination is aggregation of the heads; aggregation by tails or mixed agglutination are less frequent. In 3252 sterile women where no sperm-agglutination antibodies were found Kremer's test was negative in 1145 patients. The authors analyzed in 196 sterile women the ovulation mucus by the microagglutination test and found a high anti-spermatozoidal activity in 24 (12%) women. Concurrently an indirect MAR test was made. Antibodies against sperm cells were found in 24 (12.2%) of specimens in sIgA, in 8 (4.1%) in IgG, in 2 (2%) in IgM and in one sample (0.5%) in IgE. The indirect MAR-test in sera of 325 sterile women revealed a predominance of anti-spermatozoidal antibodies in IgG, in men in IgA. In seminal plasma the authors detected antibodies against sperm cells in sIgA. In seminal plasma the authors detected antibodies against sperm cells in sIgA and IgE.

Three years experience with local hydrocortisone treatment in women with immunological cause of infertility.

Two high selected groups of infertile women with proved cervical spermagglutinating antibodies by ficin, sucrose gradient ultracentrifugation, ELISA and microagglutinating test, by indirect MAR-test had been chosen for local hydrocortisone treatment. In the first group being composed of 20 infertile women we registered 16 decreasing or total disappearance of antisperm activity in cervical ovulatory mucus. Ten of them delivered healthy child. New 27 selected patients have treated in their immunological failure of reproduction by local hydrocortisone application, too, two of them are pregnant now. During the local hydrocortisone immunosuppression no side effects were registered. Hydrocortisone treatment seems to be a very perspective method in regulation of cervical immunological cause of infertility.

Local hydrocortisone treatment of sperm-agglutinating antibodies in infertile women.

Local sperm-agglutinating antibodies (LSAA) in the cervical ovulatory mucus may be a cause of primary infertility. A group of 17 infertile women with LSAA treated without effect with artificial insemination and then condom therapy were studied. After hydrocortisone application to the ectocervix for up to four cycles, LSAA disappeared totally in 13 patients; six of them have given birth to babies. No side effects of treatment were observed. Hydrocortisone for local immunosuppression may become a new method of therapy in cervical immunological infertility.