Antisperm antibodies are a common cause of infertility
In 20% of cases, the cause of infertility are immune factors, among which antisperm antibodies occupy a leading position. They are formed both in men and in women in reproductive organs.
Antispermal bodies are directed against variousparts of spermatozoa. They can be fixed on their membrane, inhibit movement and even cause complete immobility both in the female and in the male reproductive tract.
Also, antisperm antibodies are capable ofblock the entry of spermatozoa into the cervical canal, disrupt the interaction of the sex cells, adversely affect the fertilization and implantation of the ovum, interfere with the development of the embryo.
In the male body, sperm is formed afterpuberty, so it is not recognized by the immune system as "its own". However, there are several physiological mechanisms that protect spermatozoa from its attacks.
This barrier is called hematotestick. It prevents the entry of immune cells into the cord (seed). However, some spermatozoa still penetrate the bloodstream and trigger a reaction against themselves. Nevertheless, there are special immunological defense mechanisms in the body.
The hematotestick barrier is broken due tosurgical interventions, infectious diseases, all kinds of injuries. This creates conditions for the penetration of immune cells into the genital tract, and sperm becomes available to them. Thus, the main prerequisites for the appearance of antibodies in men are as follows:
- surgical operations and injuries in the genital area;
- varicocele;
- cryptochism;
- oncological and infectious diseases;
- clogging of the vas deferens.
In women, they begin to be developed for the following reasons:
- high content of leukocytes and erythrocytes in sperm;
- getting sperm with antisperm antibodies in the vagina;
- problems with the integrity of the mucous membranes;
- ingestion of ejaculate in the gastrointestinal tract (oral and anal sex);
- incorrect intrauterine insemination, as a result of which spermatozoa enter the abdominal cavity;
- injuries with IVF;
- coagulation of erosion.
Diagnosed in men antisperm antibodies are usually in the sperm, and the study of blood is an auxiliary method. In women, cervical mucus and plasma are tested for their presence.
Methods for the determination of antibodies:
- post-test test;
- MAR-test;
- Immunobead-test;
- latex agglutination test;
- immunoenzymatic method.
Indications for research on them:
- poor indices of spermogram (agglutination, aggregation, low mobility and viability of spermatozoa);
- presence of risk factors;
- unexplained infertility;
- deviations in the Kurzrok-Miller and Shuvarsky-Sims-Huener samples.
When antisperm antibodies are detected, treatment is necessary only if there are problems with conception. Because they do not deliver any other problems.
If the diagnosis of infertility and all otherfactors are excluded, first conservative treatment is carried out. It can include sperm washing, hormone therapy, taking medications that reduce the viscosity of mucus in the cervical canal and inhibit the production of aptysperm antibodies.
If infertility is associated with their presence in women,then the use of a condom is recommended for half a year, sometimes it is abandoned only during the period of ovulation. This is due to the fact that the less sperm enters the body, the less actively produced antibodies.
If conservative treatment does not work,then use artificial insemination, and then IVF. However, these methods are ineffective if antisperm antibodies are directed against the sperm head. Then it is necessary to use ICSI.
Today, immunological research is quite popular. One of them is a test for antinuclear antibodies. They are a marker of the development of autoimmune diseases.
So, antisperm antibodies can becomecause of immunological infertility in both men and women. Treatment is required only in this case. First, conservative methods are used, and then proceed to artificial insemination, IVF, ICSI.
