Anti-sperm Antibody Positivity in Men with Varicocele: A Systematic Review and Meta-Analysis
Purpose: Despite the significant role of varicocele in the pathogenesis of male infertility, its association with anti-sperm antibodies (ASA) remains controversial. This systematic review and meta-analysis (SRMA) aims to investigate the frequency of ASA positivity in men with varicocele. Material...
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| Main Authors: | , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Korean Society for Sexual Medicine and Andrology
2025-01-01
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| Series: | The World Journal of Men's Health |
| Subjects: | |
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| Summary: | Purpose: Despite the significant role of varicocele in the pathogenesis of male infertility, its association with anti-sperm antibodies
(ASA) remains controversial. This systematic review and meta-analysis (SRMA) aims to investigate the frequency of
ASA positivity in men with varicocele.
Materials and Methods: This SRMA is conducted in accordance with the Meta-analysis of Observational Studies in Epidemiology
guidelines. We investigated the frequency of ASA positivity in ejaculates or serum of men with varicocele as compared
to men without varicocele (controls). A literature search was performed using the Scopus and PubMed databases following
the Population Exposure Comparison Outcome, Study Design model. Data extracted from eligible studies were meta-analyzed
and expressed as odds ratios (ORs) and confidence intervals (CIs).
Results: Out of 151 abstracts identified during the initial screening, 6 articles met the inclusion criteria and were included in
the meta-analysis. Using mixed antiglobulin reaction (MAR) assay, 61 out of the 153 (39.8%) patients with varicocele tested
positive for ASA in their ejaculates as compared to 22 out of the 129 control subjects (17%, OR=4.34 [95% CI: 1.09–17.28];
p=0.04). Using direct or indirect immunobead test, 30 out of 60 cases diagnosed with varicocele (50%) had shown ASA
positivity in their ejaculates as compared to 16 out of 104 controls (15.4%, OR=3.57 [95% CI: 0.81–15.68]; p=0.09). Using
enzyme-linked immunosorbent assay (ELISA), out of 89 varicocele patients, 33 (37.1%) tested positive for serum ASA as
compared to 9 out of 57 participants in the control group (15.8%, OR=7.87 [95% CI: 2.39–25.89]; p<0.01).
Conclusions: This SRMA indicates that ASA positivity is significantly higher among men with varicocele when tested by direct
method (MAR) or indirect method (ELISA). This data suggests an immunological pathology in infertile men with varicocele
and may have implications for the management of these patients. |
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| ISSN: | 2287-4208 2287-4690 |