Antisperm Immunity and Infertility

Jin-Chun Lu; Yu-Feng Huang; Nian-Qing Lu

Disclosures

Expert Rev Clin Immunol. 2008;4(1):113-126. 

In This Article

Relationships of the Level, Subtype & in vivo Distribution of ASA With Infertility

Antisperm antibody concentration may be of importance in affecting sperm function. As the level of antibodies increases, sperm function could be impaired, and the chance of spontaneous pregnancy declines, since it is well known that men may father children in the presence of lower or equivocal titers of ASA.[33]

Although sera from women, in general, have been demonstrated to have higher titers of autoantibodies than their male counterparts, levels of ASA titers were significantly lower in women than in men.[6] High titers of ASA measured in the seminal plasma or serum of men are believed to be the main cause of their infertility.

It was reported that the subtypes of ASA focused on IgG, IgA and IgM. An elevated IgE response in subjects with significantly elevated ASA titers could be observed.

Both men and women with ASAs showed elevated total IgG levels compared with those of normal control subjects. IgG and IgM were primarily present in serum from infertile men and women. IgM was produced in the early stage when the human immune system contacted sperm antigens, and IgG arose approximately 2 weeks after the interaction between sperm antigens and immune cells. However, IgG could present in serum for a long period of time, whereas IgM levels decrease gradually.

In the genital tract, IgA was primarily present in semen, cervical mucus or follicular fluid, since the production of IgA is closely associated with mucus immunity. It was reported that the infertile men had more IgA and other secretory components in semen than controls, and that IgA was considered responsible for the reduced penetration of spermatozoa in cervical mucus and for the 'shaking phenomenon' (jittering in situ).

Antisperm antibodies can also influence the outcomes of in vitro fertilization (IVF) and the specific effect is dependent upon the subtypes of ASAs. Several authors reported that the presence of both IgG and IgA, IgM alone or IgA alone was associated with a reduced rate of fertilization.[33] In the meantime, investigators found that IgA only had an impact when a high level of binding was detected on the sperm head, and that IgM was the immunoglobulin isotype that significantly affected the fertilization rates when located at the sperm head and sperm-tail tip.[33]

Antisperm antibodies can be detected in serum, semen, cervical mucus, oviductal washings and follicular fluid. It was observed that there was no relationship between antisperm activity in the oviductal washings and that in the sera, and that the presence of ASAs in sera was not necessarily reflected in individual's genital tract secretion and vice versa. For infertile men and women, it appeared reasonable to test locally produced ASAs for their contribution to conception failure.

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