PROBLEM: During 1987–1996, cervical mucus spermagglutinating antibodies of secretory immunoglobulin A (sIgA) or IgG detected by the tray agglutination test (TAT) and the indirect mixed antiglobulin reaction (MAR) test were found in 234 women aged 23–39 years with previously unexplained infertility.
METHOD OF STUDY: Hydrocortisone was applied to the ectocervix.
RESULTS: Spermagglutinating antibodies of sIgA disappeared totally in 102 patients (91 resulting in deliveries of healthy babies, 3 in ectopic pregnancies, and 8 in spontaneous miscarriages). A decrease of spermagglutinating antibodies in ovulatory mucus during hydrocortisone application without pregnancy was registered in 60 infertile women. This group was referred to treatment by in vitro fertilization. No hydrocortisone effect on immunocompetent cells producing antispermatozoal IgG alone or combined with sIgA was seen in 72 patients.
CONCLUSIONS: Vaginal mycosis, a side effect of hydrocortisone treatment, was seen in seven cases. Hydrocortisone for local immunosuppression becomes a valuable method of therapy in cervical immunologic infertility caused predominantly by antispermatozoal sIgA.