Immuno
Antisperm Antibody Positivity and Semen Quality Phenotypes Among Infertile Men in Erbil, Kurdistan Region, Iraq
By Hewa A. Chomany, Ali Qorbanee, Shukur Wasman Smail and 5 others.
Abstract
Background
Antisperm antibodies (ASA) are recognized as a potential immunological factor in male infertility; however, their prevalence and clinical correlates remain incompletely characterized in Middle Eastern populations. This study aimed to estimate the prevalence of clinically significant ASA positivity and investigate its associations with demographic, clinical, and semen characteristics among infertile men in Erbil, Kurdistan Region of Iraq.
Methods
A multicenter retrospective cross-sectional study was conducted between July 2025 and March 2026 at urology and fertility centers in Erbil. A total of 465 infertile men were included after predefined data cleaning and MAR-test reclassification procedures. Demographic, clinical, and semen parameters were collected, and ASA status was assessed using the direct mixed antiglobulin reaction (MAR) test. Clinically significant positivity was defined as antibodies bound to ≥50% of motile spermatozoa. Associations between ASA status and participant characteristics were examined using bivariate and multivariable analyses. Additional exploratory analyses included k-means clustering of semen profiles and Random Forest machine-learning modelling to evaluate predictors of ASA positivity.