ANAHEIM, CA (UroToday.com) - The authors hypothesized that the presence of serum antisperm antibodies may distinguish between obstructive and nonobstructive azoospermia and examined whether or not serum antisperm antibodies could be utilized as a test for obstructive azoospermia. 412 men presenting for treatment of male infertility were examined, 269 with documented obstruction of the vas or epididymis and 143 with no history of obstruction. Antisperm antibody levels were assessed. The obstructed group had significantly elevated antisperm antibody levels compared to the non-obstructed group. Serum IgG, IgA, IgM, and all serum antisperm antibodies as a group were analyzed as diagnostic tests for vasal obstruction. The presence of serum antisperm antibodies was highly accurate in predicting obstructive azoospermia.

EDITORIAL COMMENTS
Althouth the authors conclude that “The presence of antibodies can obviate the need for testis biopsy to distinguish obstructive from nonobstructive azoospermia and allow the surgeon to proceed directly to surgical reconstruction or sperm retrieval.” Current practice rarely includes a diagnostic biopsy as a separate procedure. Careful physical examination and history acquisition will often allow for accurate diagnosis. Additionally, the familiarity with assessing fresh testicular tissue allows for accurate intraoperative diagnosis. That being said, ASA may at times be a useful tool in the diagnosis of the azoospermic or severely oligospermic patient. It may also be of value in the diagnosis of the male with suspected unilateral vasal obstruction.

( ABST [1927] - Infertility: Evaluation & Therapy II)

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Written by Harris M. Nagler, MD, a Contributing Editor with UroToday.

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