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Blocking experiments, using spermatozoa incubated in spermagglutinating- only sera from men which were then placed in spermimmobilising-only sera (plus complement) from women, showed that spermimmobilising a c t i v i t y was not reduced. I t is proposed, therefore, that on some occasions men and women respond to d i f fe ren t spermatozoal antigens, which of fers an explanation of the f ind ing that men commonly develop higher t i t r e s of spermagglutinating antibody than women and that women commonly have higher t i t r e s of spermimmobilising antibody.

TREATMENT OF MEN WITH AUTOIMMUNITY TO SPERMATOZOA

DAVID KAY and BARRY BOETTCHER Department of Biological Sciences, Univers i ty of Newcastle, New South Wales. 2308 Aust ra l ia .

Antispermatozoal antibodies in seminal plasma are of e i ther the IgG or IgA class of immunoglobulins. Evidence indicates that spermatozoa from autoimmune men ar r ive in the ejaculate already coated with IgG antibodies from tes t i cu la r and/or epididymal lesions, and absorb from the ejaculate secretory IgA an t i - bodies o r ig ina t ing mainly in the prostate f l u i d . IgA antibodies on seminal spermatozoa are the most e f fec t ive in i n h i b i t i n g progression of spermatozoa in the female t rac t . This information has led to the development of a t reat - ment protocol where the pat ient ejaculates d i r ec t l y in to Tyrode's so lut ion. The coagulum is extracted before l i que fac t ion , dispersed, the spermatozoa concentrated and used for i n t ra -u te r ine A.I .H. The detection of IgG and IgA on spermatozoal surfaces is undertaken by the M.A.R. and IgA Immunobead tests, respect ively.

To date, semen from 13 men has been treated in th is manner. In a l l cases s i gn i f i can t reduction and, in 5 pat ients, complete e l iminat ion of IgA on the spermatozoal surface was achieved, whi le IgG was not affected. Four pregnancies have been achieved (one pat ient twice) , one pat ient elected not to continue, four have withdrawn a f ter 3 unsuccessful cycles of insemination, one pat ient 's wife has addi t ional unresolved problems, two have elected to have addit ional immunosuppressive therapy and the others are continuing treatment. I t is suggested that th is procedure is a useful treatment for the condit ion and should be used pr io r to immunosuppression in men autoimmune to spermatozoa.

CERTAIN FACTORS THAT INFLUENCE THE EFFECTIVENESS OF CORTICO- STEROID THERAPY FOR IMMUNOLOGICAL INFERTILITY DUE TO SPERM ANTIBODIES

Subbi Mathur, H. Oliver Williamson~ Petrina V. Genc% Lea C. Perry~ Philip F. Rust and H. Hugh Fudenberg, Medical Univer- sity of South Carolina, Charleston S.C. 29425, U.S.A.

The reasons for the ineffectiveness of corticosteroids in suppression of sperm antibody titers (AB) and achievement of a pregnancy in certain infer- tile couples, are not clear. Thirty nine of 79 (49%) infertile couples without AB achieved a pregnancy after treatment for other factors. In contrast, only 6 of 105 (6%) infertile couples with AB achieved a pregnancy without cortico- steroids (P<0.001). Sixteen of 69 (23%) couples with AB and treated with pred- nisone achieved a pregnancy by 3 months, contrasted to 15 of 36 (41%) by 5 to 17 months. The percentage of couples achieving a pregnancy was significantly higher in the corticosteroid-treated than in the untreated AB positive group (P<O.001). Titers of cytotoxic AB (cytAB) in the sera of both partners and in the seminal plasma were significantly reduced in the 31 couples who achieved a pregnancy after prednisone treatment, whereas cytAB were not reduced by the treatment in the 74 couples who failed to achieve a pregnancy. Reduction of cytAB titers, improvement of post-coital tests (PCTs)and achievement of preg-