Background: There are several causes that could lead to subfertility. In 30% percent, the
cause remains unclear. Possibly, the presence of antisperm antibodies (ASA) could be a cause
of male subfertility, although there is still no consensus. Therefore, the aim of this study was
to examine the influence of ASA on subfertility.
Methods: Sperm parameters of all men who visited the outpatient clinic of the department of
gynaecology during 2003-2017 were collected. Couples with ASA positive men (≥50%) were
included in the study. The following parameters were collected: Operations and diseases
which could lead to positive ASA, medication and diseases which could possibly lead to
reduction of fertility, pregnancy rates, the way of conception, the kind of fertility treatment,
and pregnancy outcome.
Results: 175 subfertile couples with ASA positive male were included. Positive ASA
prevalence was 7,5% in the subfertile population, whereby in 33,9% a possible cause of
positive ASA was identified. The presence of positive ASA did have a significant negative
effect on the amount of oligoasthenoteratozoospermia (OAT) and teratozoospermia
(p=<0,001 and p=<0,005). Although, the presence of positive ASA did not seem to have a
negative effect on reproductive pregnancy rates. 49,7% of the couples with men with positive
ASA became pregnant without fertility treatment. 24,2% of the couples experienced a
Conclusions: The presence of positive ASA remained unexplained in the majority of males.
Our study showed the presence of positive ASA should not play a part in the decision-making
of starting a fertility treatment. It is justified to wait for 6-12 months until starting a fertility
treatment, if ASA positive men did not have an OAT and no other cause of subfertility was
observed. The presence of ASA might negatively effect the presence of miscarriages.
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