Potential causes and associated conditions with anti-sperm antibody production among infertile males: a systematic literature review.

Abstract

This study systematically reviews the literature to explore the potential causes of anti-sperm antibody (ASA) production among infertile men. A comprehensive search of PubMed was conducted in December 2024, utilizing keywords such as "anti-sperm antibody," "immunologic infertility," and related terms. The search yielded 2215 studies, which were screened by title and abstract, excluding 1857 studies. A total of 358 full-text articles were assessed for eligibility, and finally, 51 studies were included. Twenty-three thousand one hundred eight patients were involved in the included studies; 22,702 patients were infertile, and 406 were fertile controls. Infectious disease were the most commonly investigated causes of ASA production including chlamydia trachomatis infection with 9 studies. History of vasectomy and vasectomy reversal with 9 studies, varicocele (7), cryptorchidism (5), Inguinal hernia repair and other genital or inguinal surgeries (5), HPV infection (4), and seminal bacterial community and culture (4) were other potential investigated causes. Adeno-associated virus, mumps, congenital absence of vasa, testicular microlithiasis, testicular sperm extraction, testicular torsion, and testicular trauma were other causes that their correlation with ASA was explored. Vasectomy emerged as the most frequently studied factor significantly correlated with ASA production. Other conditions, like psychogenic anejaculation, prostatitis, and Buerger's disease, were also associated, though findings on some factors remain controversial. This study highlights the diverse potential causes of ASA production in infertile males, categorized into infectious, autoimmune, inflammatory, and anatomical conditions. However, the variability in results underscores the need for further research with larger populations to clarify the underlying causes of ASA production in male infertility.