Necrospermia, antisperm antibodies, and vasectomy

Objective To present a case of necrospermia and antisperm antibodies after vasectomy reversal and in which motile sperm, subsequently used in intracytoplasmic sperm injection (ICSI) treatment, was found after testicular sperm retrieval. Design Case report and literature review. Setting Reproductive medicine unit based in a women's hospital in the United Kingdom. Patient(s) A 36-year-old man with secondary infertility who presented with necrospermia and antisperm antibodies after vasectomy reversal. Intervention(s) Testicular sperm retrieval and IVF with ICSI. Main Outcome Measure(s) Presence of motile sperm in testicular sperm extraction biopsies. Result(s) Motile sperm found after testicular sperm retrieval successfully fertilized oocytes in an ICSI cycle. Conclusion(s) It appears difficult to dissociate the presence of antisperm antibodies from the necrospermia in our patient. Testicular sperm retrieval appeared to partially overcome the effect of the antisperm antibodies by retrieving sperm before they reach seminal plasma, where they would be exposed to the antibodies.