Introduction: The immune system distinguishes between exogenous and endogenous materials. The break-down of blood-testis barrier results in the production of anti-SPERM antibodies. This may occur during the infection of prostate, seminal vesicles and epididymes. AntiSPERM antibodies (ASA) cause SPERM agglutination and affect SPERM motility, VIABILITY, and migration in the female reproductive tract. ASA also impair fertilization process. The objective of the present work was to study the effect of prednisolone on the SPERM motility index (SMI), SPERM VIABILITY, and SPERM penetration assay (SPA) in immunologically infertile men.
Materials and Methods: The semen and serum samples of 140 infertile men were examined by microagglutination and slide agglutination tests to detect ASA and SPERM agglutination. Semen fluid analysis was performed to report SPERM motility index (SMI), SPERM VIABILITY, and hypo-osmotic swelling test (HOST). SPERM penetration assay was done to record SPERM penetration rate (SPR), SPERM decondensation rate (SDR), and SPERM penetration index (SPI). Men with positive ASA were treated with prednisolone and considered as treated group. Prednisolone was given orally in a dose of 5 mg three times daily for 3 months. The semen analysis, SMI, HOST, and SPA were performed before and after treatment with prednisolone. 144 semen samples were enrolled in the treated group, while 80 samples were enrolled in the control fertile group. HOST-SPA positive semen was exposed to anti-SPERM antibodies separation (ASAS) and in vitro SPERM activation prior to intra-uterine insemination.
Results: The SMI was significantly higher in the post-treatment group compared to pre-treatment group (240 vs. 52.5, P<0.01). The SPI in the control group was significantly higher than the post- and pre-treatment groups. The HOST and VIABILITY test results were significantly increased in the post-treatment group compared to pre-treatment group (73.42 vs. 48.56 and 71.36 vs. 50.74, respectively, P<0.01).
The SPERM penetration rate, SPERM decondensation rate, and SPERM penetration index were significantly increased in the post-treatment vs. pre-treatment groups (26.49 vs. 10.84, 10.91 vs. 3.47, P<0.05; 14.45 vs. 4.30, P<0.01, respectively). HOST-SPA positive semen was used for intra-uterine insemination (IUI). The semen was exposed to ASAS and in vitro activation prior to IUI and resulted in 42.86% pregnancy rate per cycle. The pregnancy was confirmed by the observation of gestational sac and viable fetal heart beat, 5 weeks following IUI.
Conclusion: It can be concluded that treatment of immunologically infertile men with prednisolone improves SMI, SPERM VIABILITY, and SPA results. The application of HOST-SPA positive semen for IUI resulted in successful pregnancy. The authors indicate that these viable SPERMatozoa with high fertilizing potential could be used for IVF and/or ICSI in immunologically infertile men.