280例不育症男性精奖浆抗精子抗体IgA与精子参数的研究

目的通过对男性患者精子质量分析,精浆抗精子抗体（antisperm antibodyAsAb）检测,分析精浆中抗精子抗体IgA与精子质量各项参数的相关性的。方法采用禁欲3-7天不育症患者的精液标本检测精子质量,进行精浆抗精子抗体检测.后对检测抗精子抗体阳性抗精子抗体阴性患者分组进行精子质量参数的统计学分析。结果280例不育男性抗精子抗体阳性率为15.35%,其精子的密度/活率活动度/均低于阴性组,两组间存在显著差异（P〈0.01）。结论精浆抗精子抗体IgA与精子密度、活率、精子活力关系密切是男性不育的主要原因之一。     

196例境外大学生入学体检时的血清抗精子抗体检测

目的探讨境外大学生入学时的血清抗精子抗体.方法 196例境外侨生,分为男性组89例,女性组107例,应用浅盘精子凝集试验和浅盘精子制动试验检测血清抗精子抗体.结果男性组和女性组各检出抗精子抗体阳性2例,抗体阳性率分别为2.3%和1.9%,男、女性2组抗体阳性率的差异没有显著性(P>0.05).结论境外大学生入学时可检出血清抗精子抗体,大学生需加强正确的性教育.     

前列腺炎合并不育症患者的抗精子抗体评价

目的评价前列腺炎合并不育症患者的抗精子抗体关系.方法应用混合球蛋白试验(MAR试验)、浅盘精子凝集试验(TAT试验)和浅盘精子制动试验(SIT),对35例前列腺炎合并不育症患者(A组)的血清和精子表面抗精子抗体进行检测,随机选择35例男性不育门诊初诊者作对照(B组).结果 A组采用TAT检出血清抗精子抗体阳性5例,滴度水平在1:8～16,SIT未测出阳性,采用MAR试验检出精子表面抗体阳性8例.B组采用TAT检出血清抗体阳性4例,SIT阳性1例,采用MAR试验检出精子表面抗体阳性2例.经t检验,A组精子表面抗精子抗体阳性率显著高于B组(P＜0.01).结论前列腺炎合并不育症患者存在着精子免疫因素,且表现出精子表面抗体发生率升高,临床对这类不育患者治疗要重视前列腺炎的抗炎处理.     

人抗精子抗体,补体及白细胞杀伤精子作用的研究

虽有一些报道认为白细胞在精液中异常增多，对精子活动力有一定的影响，但至今对白细胞精子症中白细胞及其产物抗生育机制的许多环节仍未完全了解，用人外周血白细胞，人抗精子抗体血清，人补体血清以正常人精子按析因试验设计，体外培养观察精子死亡率，实验结果，白细胞具有较强的直接杀伤精子作用，这种作用在抗精子抗体存在下有所加强，但补体存在，杀伤力并不表现增强，抗精子抗体和补体一起则可表现出一定程度细胞毒效应，而抗     

大庆地区少精子弱精子性不育症与抗精子抗体相关性的研究

目的本研究的目的是通过对男性不育患者的精液检测分析、少精子弱精子患者血清抗精子抗体的测定,探讨本地区男性不育症中少精子、弱精子的比例以及与抗精子抗体的相关性。方法通过对150例男性不育患者精液检测分析、根据精液常规结果将男性不育患者分组,研究精液正常组和少、弱精子组,统计两组患者血清抗精子抗体的阳性率。结果精液正常组87例,抗精子抗体阳性5例,占5.75%,其中少、弱精子组63例,抗精子抗体阳性32例,占50.79%,少、弱精子组抗精子抗体阳性率50.79%明显高于对照组5.75%,其差异有显著意义。结论少、弱精子与抗精子抗体有关。     

精浆抗精子抗体影响精子DNA完整率的临床观察

目的研究精浆抗精子抗体(AsAb)对精子DNA完整率的影响。方法实验前取配偶怀孕后半年内正常精液标本20例测定精子DNA完整率做预试验,其数值拟做疗效参考指标。选择2008年4月至2011年1月来我院生殖中心就诊的特发性弱精子症门诊患者432例。检验其精浆抗精子抗体和精子DNA完整率。结果在432例病人中抗精子抗体阳性患者有45例,占总数的10.42%。抗精子抗体阳性组与正常组比较,在液化时间、精子密度、精子存活率、DFI(%()精子DNA断裂指数)上存在差异,具有统计学意义(P<0.05)。抗精子抗体阳性组与阴性组比较,在液化时间、精子密度、和排精量上存在差异,具有统计学意义(P<0.05)。抗精子抗体阳性组与阴性组比较,在精液pH值、DFI上无明显差异,无统计学意义(P>0.05)。结论精浆抗精子抗体(AsAb)对精子DNA完整率的影响不明显。     

男性不育患者精子Na^＋-K^＋-ATP酶与抗精子抗体的关系

目的观察男性不育患者精子的Na＋-K＋-ATP酶的活性与抗精子抗体的关系。方法采用ELISA法测定男性不育组和正常生育组血清中的抗精子抗体,再分别测定40例抗精子抗体阳性的男性不育组和40例抗精子抗体阴性的正常生育组精子中Na＋-K＋-ATP酶的活性。结果抗精子抗体阳性的男性不育组精子中Na＋-K＋-ATP酶活性为12.0±6.1μmol.pi/107sperm/h,显著低于抗精子抗体阴性的正常生育组41.1±8.2μmol.pi/107sperm/h。（P〈0.05）。结论血清中抗精子抗体作为男性不育的指标之一,其可能通过降低精子的Na＋-K＋-ATP酶活性而导致男性不育。     

抗精子抗体含量的检测及其临床意义

目的探讨抗精子抗体(AsAb)含量与不孕、不育症的关系.方法采用酶联免疫吸附(ELISA)法对不孕、不育组和对照组的血清进行抗精子抗体含量定量检测.结果不孕、不育组血清中抗精子抗体含量明显高于对照组(P＜0.01).结论抗精子抗体是引起免疫性不孕不育的常见原因之一.     

精浆抗精子抗体对男性不育症患者精液参数的影响分析

目的分析男性不育症患者精浆抗精子抗体对精液相关参数的影响.方法收集男性不育症患者260例,均采用免疫珠法测定精浆抗精子抗体(AsAb,IgA或IgG型),根据结果分为AsAb阳性组(41例)和阴性组(219例).结果在这260例男性不育症患者中精浆抗精子抗体检出率为15.77%.AsAb阳性组患者的精液主要参数(精液密度、活动率、a b活动力)均低于AsAb阴性组患者,两组间比较差异具有显著性(P<0.05).结论精浆抗精子抗体对精液主要参数有明显影响,是导致男性免疫性不育的重要因素之一.     

抗精子抗体阳性不孕妇女采用避孕套疗法后的抗体水平改变

本文选择抗精子抗体阳性的不孕妇女 ,观察其应用避孕套疗法后的抗体水平改变。结果表明 ,16例抗精子抗体不孕妇女采用避孕套疗法 8个月～ 2 5年后 ,11例患者的抗精子抗体滴度有不同程度的降低 ,治疗前凝集抗体阳性在 1:8～1:16水平的患者 (n =10 )中有 7例转为阴性 ,其中 4例妊娠 ;治疗前凝集抗体≥ 1:32水平或合并制动抗体阳性者 (n =6 )在治疗期未获妊娠。提示避孕套疗法对血清凝集抗体滴度低者易转为阴性 ,抗体滴度高或制动抗体阳性者可能会无效果。     

Reproductive immunology: relevance to infertility practice

Both, men and women can develop antisperm antibodies as the response to numerous factors, however immune-mediated infertility is a relative condition, i.e. may reduce but not totally prevent fertility. Different techniques can detect antisperm antibodies and show how these antibodies may interfere with fertilization process. To overcome immune-mediated infertility, the immunosuppressive therapy and in vitro treatment of antibody-coated sperm cells including in vitro fertilization have been proposed.     

The significance of antisperm antibodies for sperm-cervical mucus interaction.

An overview is presented of the effects of antisperm antibodies on the sperm-cervical mucus interaction. Antisperm IgA on spermatozoa or in cervical mucus can severely inhibit sperm penetration of cervical mucus and migration through it. Disturbance of the sperm-cervical mucus interaction is the only firmly established effect of these antisperm antibodies and leads to reduced fertility, as shown by a poor or negative result of the post-coital test. The presence of antisperm IgA in the male or female partner can be investigated more specifically with the sperm-cervical mucus contact test and can be confirmed by the sperm agglutination test on bromelinliquefied cervical mucus, by the mixed antiglobulin reaction test or by the immunobead test for IgA.     

The Use of ELISA to Evaluate Human Antibody Binding to Epididymal Sperm From Different Species

PROBLEM: The impact of antibodies to epididymal sperm antigens in human infertility has been poorly understood. Cross-reactivity of human antibodies with animal epididymal sperm has been previously observed, however, only by means of qualitative methods. Moreover, it has been always compared to reactivity against human ejaculated rather than human epididymal sperm. METHOD: Following a screening study of 940 infertility patients, sperm agglutinating and immobilizing sera as well as sperm anbitody negative controls were used to standardize an ELISA employing human ejaculated sperm. Nine sera positive in ELISA were further tested against epididymal human, guinea pig, rat, and hamster sperm. Differences among groups were evaluated by factorial analysis of variance (ANOVA). RESULTS: The specificity and sensitivity of ELISA were shown to be 85.1% and 61.18%, respectively. Eight out of nine antisperm antibody-positive sera from infertile subjects reacted relatively stronger with epididymal than with ejaculated human sperm. All tested infertility sera showed strong although variable cross-reactivity with sperm from guinea pig, hamster, and rat. CONCLUSION: ELISA has definite potential in sperm antibody research, allowing quantitative assessment of the results and immotile sperm employment. The suggested predominant role of epididymal sperm antigens in immune responses related to fertility needs further investigation. Some of these antigens are obviously phylogenetically perserved, and possibly in a quantitative aspect present differently on epididymal spermatozoa from various mammalian species.     

Identification of Human Sperm Antigen Recognized by Serum of an Immunoinfertile Woman: A Candidate for Immunocontraception

PROBLEM: It has been well documented that antisperm antibodies can be causative factors of infertility. In this study we have identified an antigen on human sperm surface using serum of an immunoinfertile woman; it is thus a candidate for immunocontraception. METHOD: Thirty-three women of reproductive age who were infertile were screened for presence of antisperm antibodies by indirect immunofluorescence and agglutination assay. The serum of one such woman, SU-4, reacted with her husband's as well as normal donor sperm and recognized a band of apparent molecular weight of 71-kDa on Western blot. Anti-71 -kDa antiserum was raised in rabbit by eluting 71 -kDa protein and was characterized by agglutination test, immunofluorescence assay, transmission electron microscopy, flow cytometry, and sperm-egg interaction in mouse system. RESULTS: Interestingly, sera raised in rabbit against 71-kDa antigen, was identified by immunoinfertile serum of SU-4, revealed similar results of localization of human acrosome. Anti-71-kDa antibodies showed cross-reactivity with other species of sperm, demonstrated inhibition of sperm attachment to oocytes in an in vitro mouse system, and revealed surface binding of human live sperm by flow cytometry. Transmission electron microscopy documented the presence of 71-kDa antigen in the acrosomal compartment. CONCLUSION: This study has put in evidence an antigen of apparent molecular weight of 71-kDa in all donor sperm tested in this study. The presence of this antigen on the sperm of several species will enable us to determine the efficacy of this antigen in controlling fertility in vivo in both rodents and primates. This antigen may be a candidate for immunocontraception.     

The poor prognostic value of low to moderate levels of sperm surface-bound antibodies.

The clinical significance of antisperm antibodies for fertility remains controversial. In this study, we determined whether the presence, isotype, region and/or amount of sperm-bound antibody was of any predictive value for future fertility in 534 men using Cox's proportional hazards model. Significant correlations between the presence of antibodies and semen parameters were recorded, such as sperm mucus penetration and sperm motility. However, low (less than 10%) negative binding and moderate (less than 50%) binding had no significant effect on the probability of conception or the time to conception. This study confirms in-vitro data suggesting that sperm function is not impaired unless the degree of antibody binding to spermatozoa is very high.     

Antisperm Antibodies: Invaluable Tools Toward the Identification of Sperm Proteins Involved in Fertilization

The identification of sperm proteins involved in fertilization has been the subject of numerous investigations. Much interest has been dedicated to naturally occurring antisperm antibodies (ASA) and their impact in fertility. Their presence in men and women has been associated with 2–50% of infertility cases. ASA may impair pre‐ and post‐fertilization steps. Experimental models have been developed using sperm proteins as immunogens to evaluate their involvement in sperm function. Our team has pursued investigations to assess ASA presence in biological fluids from patients consulting for infertility and their effect on fertilization. We found ASA in follicular fluids with ability of inducing the acrosome reaction and blocking sperm–zona pellucida interaction and used them to identify sperm entities involved in these events. We generated and utilized antibodies against proacrosin/acrosin to characterize the sperm protease system. We implemented an ELISA to detect proacrosin/acrosin antibodies in human sera and evaluated their impact upon fertility by developing in vitro assays and a gene immunization model. This review presents a summary of ASA history, etiology, current approaches for detection and effects upon fertility. ASA (naturally occurring, generated by animal immunization and/or of commercial origin) are invaluable tools to understand the molecular basis of fertilization, better diagnose/treat immunoinfertility and develop immunocontraceptive methods.     

Fertility of male guinea-pigs immunized with testicular antigen in Freund''s incomplete adjuvant

Male guniea-pigs, immunized with testicular antigens in Freund's incomplete adjuvant, were mated. The presence of antisperm antibodies in the sera of guinea-pig boars did not result in infertility, decreased fertility or diminished litter size, although γ-globulin persisted on the epididymal sperm of immunized animals for prolonged periods.     

Natural and induced immunological infertility

Given the observation that naturally occurring antibodies to eggs and sperm can cause infertility, it seems feasible to pursue development of an infertility vaccine based on the induction of a specific immune response to gamete or early embryo antigens. Antibodies directed to the zona pellucida have been researched, but at current levels of purification, result in reduced ovarian hormone production. Of the numerous sperm antigens, LDH-C4 appears most promising for use in a vaccine. In the past decade, antisperm antibody investigations have focused on surface antibodies and sperm mixed agglutination reactions. It appears that antibodies in accessory fluids bind to sperm during ejaculation and/or antisperm antibodies enter the male tract at the epididymal level or higher. Antibodies directed against egg or sperm may prevent or modify the normal process of capacitation in which sperm undergo a series of biochemical and morphological transformations. Antisperm antibodies can suppress fertility by preventing sperm transport through cervical mucus or impeding the sperm-egg interaction during fertilization. The definition of sperm antigens associated with infertility--essential for development of a contraceptive vaccine--is being facilitated by monoclonal antibody techniques and DNA technology. Since the sperm surface is organized into highly specialized and distinct regions, cell recognition is an important research area. Most salient to the recognition and regulation of cell interaction are the components of the sperm plasma membrane and the zona pellucida.     

Modalities for treatment of antisperm antibody mediated infertility: novel perspectives

Immunoinfertility because of antisperm antibodies (ASA) is an important cause of infertility in humans. The incidence of ASA in infertile couples is 9-36% depending on the reporting center. Early claims regarding the incidence and involvement of ASA in involuntary infertility were probably overemphasized, which has resulted in subsequent confusion, doubt, and underestimation of their clinical significance. No immunoglobulin that binds to sperm should be called an antisperm antibody in a strict sense unless it is directed against a sperm antigen that plays a role in fertilization and fertility. ASA directed against the fertilization-related antigens are more relevant to infertility than the immunoglobulins that bind to sperm associated antigens. Several methods have been reported for treatment of immunoinfertility. These include: immunosuppressive therapies using corticosteroids or cyclosporine; assisted reproductive technologies such as intrauterine insemination, gamete intrafallopian transfer, in vitro fertilization, and intracytoplasmic sperm injection; laboratory techniques such as sperm washing, immunomagnetic sperm separation, proteolytic enzyme treatment, and use of immunobeads. Most of the available techniques have side effects, are invasive and expensive, have low efficacy, or provide conflicting results. Recent findings using defined sperm antigens that have a role in fertilization/fertility have provided animal models and innovative novel perspectives for studying the mechanism of immunoinfertility and possible modalities for treatment. The better understanding of local immunity and latest advances in hybridoma and recombinant technologies, proteomics and genomics leading to characterization of sperm antigens relevant to fertility will help to clarify the controversy and to establish the significance of ASA in infertility.     

Antisperm antibody detection using concurrent cytofluorometry and indirect immunofluorescence microscopy.

Anti-sperm antibodies from serum and seminal plasma were detected by concurrent flow cytometry and epifluorescence microscopy using fluorescein-conjugated antihuman immunoglobulins. Experimental conditions were designed, taking advantage of several monoclonal antisperm antibodies, to test aspects of the assay before clinical application. Perturbation of membrane integrity altered both the localization of binding and the number of sperm cells positive for bound antibodies. In specimens from selected infertility patients, 21.6% of the females and 40.8% of the males had significant levels of antisperm antibodies. Differences in the incidence of isoimmunity between female partners of antibody-positive or antibody-negative males and differences in the localization of antigens targeted by serum versus seminal plasma antibodies in men support the idea that, in some cases, immunity to sperm cells may be the result of altered sperm antigens.