Dr. Brummer Cosmina

Obstetrică - ginecologie

Râmnicu Vâlcea, APOGEU

The antisperm antibodies in the female possibly adversely affects fertilization , embryo quality and pregnancy rates .
Cervical hostility includes a variety of disorders including anatomical , hormonal and immunological conditions . In most cases it is diagnosed by the PCT (Post Coital Test).
Cervical mucus can become hostile to spermatozoa and impair ascent in the uterus . Mucus is said to be hostile if the spinnbarkeit appearance is abnormal during the infertility work-up . Mucus secretion and viscosity mab be reduced during prolonged estrogen deficiency , or with infection caused by Trichomonas and Chlamydia .

Antibodies can impair sperm motility and function by causing :
-Agglutination ;
-Reduced or total loss of motility ;
-Impaired cervical mucus penetration ;
-Alterations in capacitation and acrosomal reaction ;
-Inefficient sperm-egg fusion .

The primary indication for testing antisperm antibodies is the abnormal PCT .
The test should be done :
-when there is a history of infection ;
-local injury of the testis ;
-seminal analysis revealing sperm agglutination or poor PCT ;
-very early pregnancy wastage .

Diagnosis :
-Plasma titers of antibodies found during infertility work-up ;
-IgA and IgG antisperm antibodies in the cervical mucus ;
-Non-progresive motility of spermatozoa in cervical mucus ;
-Poor PCT ;
-Huhner test or Kremer test ;
-In vitro penetration test .

Clinical effects :
-Interference with sperm production ;
-Restriction of sperm penetration and survival ;
-Reduction of sperm motility ;
-Damage of the integrity of sperm plasma membrane ;
-Interference with the sperm capacitation and / or acrosome reaction ;
-Interference with sperm/zona pellucida binding and / or penetration ;
-Inhibition of early cleavage of fertilized eggs ;
-Suppression in the development of the embryo ;
-Interference with the implantation process .

Laboratory Tests for Antisperm Antibodies:
-Sperm Mucus Contact Test ;
-Franklin and Duke’s test ;
-Kibricks’ gelatin agglutination test (GAT) ;
-Tray agglutination test (TAT) ;
-Mixed agglutination reaction (MAR) ;
-Radio labeled antiglobulin assay ;
-Panning procedure ;
-Immunobead test (IBT) ;
-Indirect IBT ;
-Enzyme-linked immunosorbent assay (ELISA) ;
-Anti-sperm antibody latex agglutination test ;
-Anti-sperm abtobody latex agglutination test Ig typing ;
-Anti-sperm antibody hemagglutination test ;
Flow cytometry (FCM);
-Immunofluorescence test .

Treatment :
1.Occlusion therapy ;
2.Condom therapy ;
3.Enzyme therapy ;
4.Immunosuppresion ; pregnancy rates of 22% where only the men were treated and 14% when only women were treated ;
5.Immunization with partners lymphocytes
6.In vitro sperm processing ;
7.Intrauterine insemination (IUI) ; the pregnancy rates vary from 23 to 40 percent ;
8.In vitro fertilization and embryo transfer (IFV and ET) ;
9.Gamete intrafallopian tube transfer (GIFT) ;
10.Artificial reproductive technique (ART).

Antisperm antibodies may also occur in proven fertile men .

Johannesburg
South Africa