Cryptorchidism is not a risk factor for antisperm antibody production in post-orchidopexy males with infertility

摘要

Introduction: Infertility in adulthood is a well-recognized consequence of cryptorchidism, even after successful orchidopexy. Autoimmune reactions against spermatozoa are associated with infertility and often found in cryptorchids. The purposes of this study were to evaluate the linkage between antisperm antibody (ASA) and cryptorchidism, and furthermore, to clarify whether ASA is involved in cryptorchidism-associated infertility. Materials and Methods: We investigated a total of 48 infertile males with a history of unilateral (n = 30) or bilateral (n = 18) cryptorchidism who had undergone successful orchidopexy in prepuberty, and 20 age-matched fertile and healthy males were collected as controls. ASA in sperm samples was detected by the direct immunobead test, and semen analysis was performed concomitantly. Results: No infertile case satisfied the diagnostic criteria of ASA-mediated infertility set forth by the World Health Organization. Decreases in both sperm concentration and motility accompanied by increases in abnormal morphology were seen in infertile cryptorchids when compared with the healthy controls. Conclusions: Testicular heat exposure in prepuberty is not a risk factor for ASA production. It is evident that the mechanisms that underlie cryptorchidism-associated infertility do not involve ASA. Poor sperm characteristics in cryptorchids resulting from thermal damage to the testes seem to be responsible for their infertility, even after successful orchidopexy.