Antisperm Antibodies

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.