Anti sperm antibodies are antibodies directed against the sperm. Under normal conditions the immune system develop antibodies to help protect our immune system against illnesses. However, in the case of anti sperm antibodies the body develops and directs specific antibodies against the sperm which is the wrong approach and can cause negative side effects upon the health status of the sperm and can cause infertility in a man. In general, among infertile men, about 10% will be diagnosed with having antisperm antibodies, a condition that can significantly decrease their chances of pregnancy.
Normally, the testes contain a natural barrier, known as the blood-testes barrier. This barrier acts as a protective layer that prevents immune cells from being able to access sperm within the male reproductive tract. Yet, this barrier can be broken, through injury to the reproductive tract, thereby allowing the immune cells to come into contact with the sperm and recognize them as foreign bodies, which they are.
Once the barrier is broken, immune cells are able to detect the presence of sperm due to their unique antigen surface. This triggers a response by the immune system to treat sperm as an "invader" and attack it. Antibodies then attach themselves to different parts of the sperm and interfere with male fertility in a number of ways.
Normally there are three different types of antibodies produced by the body that can influence the well being of the sperm. Antibodies that are located on the tail of sperm can cause the sperm to become immobilized or clump together. When antibodies are found on the head of sperm, they can prevent the sperm from being able to efficiently make its way through a woman’s cervical mucus to the egg. Interestingly enough, it is also possible for a woman to develop antisperm antibodies in her cervical mucus, which will only serve to hinder attempts at conception even more. It is thought that antisperm antibodies in cervical mucus could account for as much as 40% in unexplained infertility cases.
Under normal conditions, sperm that does manage to make it to the egg encounter a great deal of difficulty properly binding and fertilizing the egg due to antibodies attached to its head. The etiology for the production of antisperm antibodies are several.
It has been documented very clearly that men who have undergone a
vasectomy reversal are particularly prone to developing this fertility
problem. Publish reports put to 70% of men who have had their vasectomy
reversed will develop antisperm antibodies.
How can Antisperm Antibodies be treated?
The detection of antisperm antibodies is usually fairly simple as a semen analysis should be able to identify whether the antibodies are present. It is also possible to do an individual test that looks specifically for antisperm antibodies on sperm or, in women, in cervical mucus. However, getting rid of the antibodies may not be as easy. Our Scientific Director, Professor Zavos has developed a noble means via which these antibodies may be treated1. While the use of corticosteroids can decrease the number of antibodies, temporarily restoring fertility, it is necessary to use very high doses. These high doses often cause serious side effects and it is not a desirable way of treating such problems. Women who have antisperm antibodies may be prescribed medications to suppress their immune system, as well.
With the advent of IVF and the various other forms of Assisted reproductive techniques they have been found to be the most helpful for couples suffering from this problem. In some instances some couples have found success with IUI as this involves depositing sperm directly into the uterus. This technique appears to work best in couples whose difficulties stem from the cervical mucus. Washing sperm before the procedure can also rid the sperm of most antibodies from the male.
Overall however the various ARTs have been found to offer the best results but this comes with the cost of having an IVF cycle with ICSI. One must remember that "washing" sperm beforehand is often helpful but such process has to be done with a great deal of care and use of special buffering systems.
1Zavos, P.M., Correa, J.R., Zarmakoupis-Zavos, P.N.: Antisperm antibody treatment mode: levels of antisperm antibodies following incubation in TEST-Yolk buffer and filtration via the Sperm Prep II method. Fertility and Sterility, 69(3):517-21, 1998.
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