QuestionDear Edward Joseph Ramirez, my husband and I suffer from idiopathic infertility. Except that my husband was diagnosed positive ASA with MAR direct (90% bounded spermatozoids) and indirect (80% bounded spermatozoids) method, all results are good. He went to urologist, and since he couldn't find cause for it he sent him to do ELISA test from serum which came up negative. For past two years he repeated these tests several times in different laboratories, every time with same results - MAR positive and ELISA negative. Urologist refuse to give him any medical treatment since results are confusing. How is this possible? Which of these tests is more reliable?
AnswerHello Sandra from Serbia,
Since your husband's sperm shows antisperm antibodies, you should just proceed from there. I think you have done enough repeat tests, and there is NO treatment that a Urologist can do to change that, unfortunately.
With antisperm antibodies, you husband is forming antibodies that attache to the sperm and prevent them from being able to fertilize an egg. This leads to a functional defect. The treatment of choice in this regard, and for this problem, is to undergo ICSI in conjunction with IVF so that the sperm can be washed and the antibodies removed. This can be done for IUI but does not work as well. Once the sperm are washed, they can then be injected into the eggs for fertilization to take effect.
I cannot explain or debate the effectiveness of these testing methods, as I am not a biochemist and not well versed on these testing methods.
Good Luck,
Edward J. Ramirez, M.D., FACOG
Executive Medical Director
The Fertility and Gynecology Center
Monterey Bay IVF Program
www.montereybayivf.com
Monterey, California, U.S.A.
for additional information check out my blog at http://womenshealthandfertility.blogspot.com check me out on facebook and twitter with me at @montereybayivf
