Twenty-five infertile couples in which the male had antisperm antibodies were treated by in vitro fertilization (IVF), zygote intrafallopian transfer, or gamete intrafallopian transfer in 38 cycles. In 10 females a tubal pathology was present, and in the normal female patients repeated intrauterine insemination with husband sperm had failed. The presence of an andrological factor in 17 male patients did not influence the fertilization and the cleavage of the retrieved oocytes. Although the fertilization rate of 45.8% was significantly lower than in patients with tubal pathology, the pregnancy rate was 34.2% per started cycle and 44.8% per replacement. Furthermore, the embryos were of lesser quality than in couples with tubal and idiopathic infertility. This study suggests that IVF could be considered as a useful therapeutic approach for couples with a positive direct mixed antiglobulin reaction test before advising them the use of heterologous sperm.