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 various parts 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 able to block the entry of spermatozoa into the cervical canal, disrupt the interaction of the sex cells, negatively influence the fertilization and implantation of the egg, and interfere with the development of the embryo.

In the male body, semen is formed after puberty, 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, in the body there are special immunological mechanisms of protection.

The hematotestick barrier is broken due to surgical 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.

At women they start 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;
• Ejaculation 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 antispermal 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. Since they do not deliver any other problems.

If the infertility is diagnosed and all other factors are excluded, first conservative treatment is performed. It can include sperm washing, hormone therapy, taking drugs 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 a woman, then recommend the use of a condom within six months, 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 artificial insemination is used, followed by 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 is the test for antinuclear antibodies. They are a marker of the development of autoimmune diseases.

So, antisperm antibodies can cause immunological infertility in both men and women. Treatment is required only in this case. First, conservative methods are used, and then go on to artificial insemination, IVF, ICSI.