58 Following vasectomy reversal, pregnancy rates are reduced when these ASA are present in the seminal fluid or detected on spermatozoa. However, this occurs relatively infrequently when men who have had vasectomy reversal are studied. Meinertz and colleagues studied a group of 216 men following vasovasostomy with mixed antiglobulin reaction (MAR) for IgG, IgA, and IgA U0126 mouse secretory antibodies bound to sperm. ASA in serum and seminal plasma were detected by agglutination tests.59 In the subgroup with a pure IgG

response, the conception rate reached 85.7%, whereas only 42.9% of men who also had IgA on their sperm achieved a pregnancy. When 100% of the spermatozoa were coated with IgA, the conception rate was reduced to 21.7%. Isahakia et al.60 have shown, in baboons, that new antigens are expressed on developing spermatocytes and spermatids after initiation of spermatogenesis. Three monoclonal antibodies (Mabs) raised in mice immunized with baboon sperm were used to study the stage-specific expression of sperm-associated antigens on intratesticular sperm. One of these Mab’s recognized a moiety on the sperm tail and the other over the anterior acrosomal region of the sperm. The tail antigen was absent in 2- and 3-year-old baboon testes, first appearing in spermatids located close to

the lumen of the seminiferous tubules at CH5424802 solubility dmso about 4 years of age. The acrosomal antigen was recognized in late pachytene spermatocytes and round spermatids in a 3-year-old animal, but failed to be demonstrated in a 2-year-old juvenile baboon. These antigens, to which the immune system may not be tolerant, could play a role in the genesis of autoimmunity sperm. As men with acquired sperm obstruction (secondary to vasectomy) develop autoimmunity to sperm, we asked whether men with cystic fibrosis, the majority of whom exhibit obstructive azoospermia due to congenital absence of the body & tail of the epididymis, the vas deferens,

and seminal vesicles, exhibited ASA in their serum. We also wanted to determine whether there was a relationship between puberty (at which time filipin spermatogenesis becomes active) and the development of autoimmunity to sperm. We studied 15 males, using an Immunobead binding assay, to detect the presence of ASA in their serum.61 Six of 7 post-pubertal males (ages 18-33) were found to possess ASA in their serum. These men were judged post-pubertal by their testes volume and serum testosterone levels. Conversely, none of 8 pre-pubertal (ages 9–11) were found to have autoimmunity to sperm. An additional control consisted of 16 diabetic post-pubertal males, one of whom was found to exhibit ASA. There is increasing evidence that the blood–testes barrier in itself is not sufficient to prevent autoimmunity to sperm.