Immunoglobulin G antisperm antibodies and prediction of spontaneous pregnancy

Esther Leushuis*, Jan Willem van der Steeg, Pieternel Steures, Sjoerd Repping, Willem Schöls, Fulco van der Veen, Ben Willem J. Mol, Peter G.A. Hompes

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

26 Citations (Scopus)


Objective: To investigate the predictive capacity of immunoglobulin G ASA (direct MAR test) for spontaneous ongoing pregnancy in subfertile couples. Design: Prospective cohort study. Setting: Nine fertility centers in The Netherlands. Patient(s): Consecutive ovulatory subfertile couples. Intervention(s): A basic fertility workup, including a mixed agglutination reaction test for IgG (MAR test) at first semen analysis. Main Outcome Measure(s): Spontaneous conception resulting in ongoing pregnancy. Result(s): We included 1,794 couples, of which 283 (16%) had a spontaneous ongoing pregnancy within 1 year. When a threshold 50% was used for an abnormal test result, the MAR test was positive in 3% of the couples. In the univariable analysis, a positive MAR test ≥50% reduced, albeit not statistically significant, the probability of spontaneous pregnancy (hazard ratio [HR] 0.76, 95% confidence interval [CI] 0.34 to 1.7). In the multivariable analysis, a positive MAR test ≥50% had no contribution in the prediction of spontaneous pregnancy (HR 0.99, 95% CI 0.40 to 2.4). Conclusion(s): This large cohort study shows that the MAR test is not able to predict spontaneous pregnancy chances. Its routine use in the basic fertility workup for identification of couples with low spontaneous pregnancy chances is not justified.

Original languageEnglish
Pages (from-to)1659-1665
Number of pages7
JournalFertility and Sterility
Issue number5
Publication statusPublished - 1 Nov 2009


  • antisperm antibodies
  • Mixed agglutination reaction
  • ongoing pregnancy
  • prospective cohort
  • spontaneous pregnancy
  • subfertility


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