Determination of anti sperm antibody before and after varicocelectomy

Varicocel is known as one of the most common causes for male infertility which occurs by means of different mechanisms. In particular immunological reasons such as anti sperm antibody (ASA) may have role such infertility. Although varicocelectomy is identified as a risk factor producing ASA، its role is not fully understood، while the impact of some other surgeries including vasectomy، orchiopexy and testis biopsy and infection on the production of ASA have already been well recognized. Upon clinical examination، 65. Varicocel patients، whose were candidate for varicocelectomy surgery، were selected. A prospective study for an assessment of ASA level in semen and serum pre and post surgery was conducted. The level of ASA was measured by direct and indirect sperm-MAR-test. Over 15% ASA level was considered as positive result. 60 patients with the mean age of 24 (18-33) completed the study. The semen analysis after surgery showed recovery regarding all three parameters including sperm count، motility and morphology، where changes in count and motility revealed significant (p<0. 05) differences. 29 % of patients before surgery showed positive level of ASA (20-40%)، whose ASA level 3-month after surgery yielded 53 %، and serum level of ASA before and after surgery displayed significant (P=O. 03l) differences. In semen، however، the level of ASA did not show any differences (p=0. 772). After surgery، semen parameters were compared within ASA positive and negative patients and significant (p= 0. 035) differences were observed in terms of motility. Within patients with negative ASA before surgery، 48 patients showed ASA level about 5-15% with no effect on semen parameters. Based on our findings، it can be concluded that varicocelectomy may cause positive ASA levels in serum of patients after surgery. However، in comparison with patient with negative ASA after surgery، no fluctuation in the semen parameters can be seen except reduction in motility. Since varicocelectomy displayed no effect on semen ASA، thus varicocelectomy do not trigger unfavorable effects، even if it initiates some increase in serum ASA.