Purpose: To present strategies in diagnosing and treating infertility related to antisperm antibodies. Methods: Antisperm antibodies (ASA) were detected on sperm using the direct immunobead (IBD) test. Treatments included intrauterine insemination (IUI) with pretreatment with chymotrypsin/galactose vs in vitro fertilization (IVF) with intracytoplasmic sperm injection (ICSI). Results: Intrauterine insemination with protein digestive enzyme treatment was much more effective than IUI without enzymatic therapy. However IVF with ICSI provided three times the pregnancy rate for males with sperm coated with ASA than IUI with chymotrypsin treated sperm. Conclusions: It is advisable to include measurement for ASA on the initial semen analysis. However, another option is to perform it initially only with an abnormal post-coital test. The decision for IUI with chymotrypsin pretreatment of the sperm vs IVF with ICSI may depend on insurance and financial issues.