Antisperm Antibody Testing: A Comprehensive Review of Its Role in the Management of Immunological Male Infertility and Results of a Global Survey of Clinical Practices

Sajal Gupta, Rakesh Sharma, Ashok Agarwal*, Florence Boitrelle, Renata Finelli, Alaa Farkouh, Ramadan Saleh, Taha Abo Almagd Abdel-Meguid, Murat Gül, Birute Zilaitiene, Edmund Ko, Amarnath Rambhatla, Armand Zini, Kristian Leisegang, Shinnosuke Kuroda, Ralf Henkel, Rossella Cannarella, Ayad Palani, Chak Lam Cho, Christopher C.K. HoDaniel Suslik Zylbersztejn, Edoardo Pescatori, Eric Chung, Fotios Dimitriadis, Germar Michael Pinggera, Gian Maria Busetto, Giancarlo Balercia, Gianmaria Salvio, Giovanni M. Colpi, Gökhan Çeker, Hisanori Taniguchi, Hussein Kandil, Hyun Jun Park, Israel Maldonado Rosas, Jean de la Rosette, Joao Paulo Greco Cardoso, Jonathan Ramsay, Juan Alvarez, Juan Manuel Corral Molina, Kareim Khalafalla, Kasonde Bowa, Kelton Tremellen, Evangelini Evgeni, Lucia Rocco, Marcelo Gabriel Rodriguez Peña, Marjan Sabbaghian, Marlon Martinez, Mohamed Arafa, Mohamed S. Al-Marhoon, Nicholas Tadros, Nicolas Garrido, Osvaldo Rajmil, Pallav Sengupta, Paraskevi Vogiatzi, Parviz Kavoussi, Ponco Birowo, Raghavender Kosgi, Saleem Bani-Hani, Sava Micic, Sijo Parekattil, Sunil Jindal, Tan V. Le, Taymour Mostafa, Tuncay Toprak, Yoshiharu Morimoto, Vineet Malhotra, Azin Aghamajidi, Damayanthi Durairajanayagam, Rupin Shah

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

8 Citations (Scopus)


Antisperm antibodies (ASA), as a cause of male infertility, have been detected in infertile males as early as 1954. Multiple causes of ASA production have been identified, and they are due to an abnormal exposure of mature germ cells to the immune system. ASA testing (with mixed anti-globulin reaction, and immunobead binding test) was described in the WHO manual 5th edition and is most recently listed among the extended semen tests in the WHO manual 6th edition. The relationship between ASA and infertility is somewhat complex. The presence of sperm agglutination, while insufficient to diagnose immunological infertility, may indicate the presence of ASA. However, ASA can also be present in the absence of any sperm agglutination. The andrological management of ASA depends on the etiology and individual practices of clinicians. In this article, we provide a comprehensive review of the causes of ASA production, its role in immunological male infertility, clinical indications of ASA testing, and the available therapeutic options. We also provide the details of laboratory procedures for assessment of ASA together with important measures for quality control. Additionally, laboratory and clinical scenarios are presented to guide the reader in the management of ASA and immunological male infertility. Furthermore, we report the results of a recent worldwide survey, conducted to gather information about clinical practices in the management of immunological male infertility.

Original languageEnglish
Article numberA10
Pages (from-to)380-398
Number of pages19
JournalWorld Journal of Men?s Health
Issue number3
Publication statusPublished - Jul 2022


  • Antibodies
  • Infertility, male
  • Sperm agglutination
  • Spermatozoa
  • Survey

ASJC Scopus subject areas

  • Reproductive Medicine
  • Ageing
  • Health Policy
  • Public Health, Environmental and Occupational Health
  • Psychiatry and Mental health
  • Urology
  • Pharmacology (medical)


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