无精子症配偶宫颈粘液内的抗精子抗体分析

目的：研究无精子症男子配偶宫颈粘液中的抗精子抗抗体。方法：应用ＥＬＩＳＡ方法检测宫颈粘液中的抗精子抗体。结果：４００例有精子男子配偶中９２例为抗精子抗体阳性（２３％），２００例无精了症男子配偶中４２例为抗精子抗体阳性（２１％），两组比较差异不显著。结论：无精子症病人配中抗精子抗体的产生可能是精浆中的精子吸附怕的结果。     

人类抗精子抗体对精子功能的影响——1.人类抗精子抗体对精子穿越宫颈粘液的影响

为探讨抗精子抗体对精子穿越宫颈粘液能力的影响,本文用15份含高滴度抗精子抗体的血清配成不同稀释度的血清标本,用间接精子免疫珠结合试验测定各血清标本的抗体滴度,并用精子宫颈粘液穿透试验检测不同滴度抗精子抗体对精子穿越宫颈粘液能力的影响。结果显示:(1)IgA和IgG类抗精子抗体对精子穿越宫颈粘液的能力均有明显影响(P<0.01),且IgA类较IgG类作用大。(2)头部及全身结合有抗体的精子受损较明显,而仅尾部结合有抗体的精子则无明显受损。(3)当结合抗体的活动精子≥60％或头及全身结合抗体的活动精子≥30％时这种影响变得十分确切。     

人类抗精子抗体对精子功能的影响：1.人类抗精子抗体对精子穿越宫颈…

为探讨抗精子抗体对精子穿越宫颈粘液能力的影响，本文用１５份含高滴度抗精子抗体的血清配成不同稀释度的血清标本，用间接精子免疫珠结合试验测定各血清标本的抗体滴度，并用精子宫颈粘液穿透试验检测不同滴度抗精子抗体对精子穿越宫颈粘液能力的影响。     

IgA抗精子抗体对精子顶体反应的影响

目的 探讨精浆中IgA抗精子抗体对人精子顶体反应的影响。方法 利用免疫珠法（IBT）筛选出IgA抗精子抗体阳性精浆标本同正常人精子孵育，以孕酮诱发精子顶体反应；以特异性荧光标记物．络合异硫氰酸荧光素的花生凝集素（FITC-PNA）标记精子顶体，通过流式细胞仪检测精子顶体完整性。结果 与IgA抗精子抗体阳性精浆孵育的精子，其孕酮诱发的顶体反应发生率明显低于正常精浆及精子培养液组（P〈0．01），正常精浆组及精子培养液组间无显著性差异（P〉0．05）；IgA抗精子抗体阳性精浆组、正常精浆组、精子培养液组自发顶体反应的发生率无显著性差异（P〉0．05）。结论 免疫性不育患者精浆中的IgA抗精子抗体可以明显抑制孕酮诱发的顶体反应的发生，可能是导致不育的原因之一。     

解脲支原体感染与抗精子抗体阳性及其男性不育症的关系

目的：探讨在男性不育症中解脲支原体感染与抗精子抗体阳性的关系。方法：采用混合抗球蛋白反应方法检测50例尿道分泌物解脲支原体Uu阳性不育症患者精液中抗精子抗体与56例尿道分泌物解脲支原体Uu阴性不育症患者精液中抗精子抗体。结果：在106例不育症患者中，解脲支原体Uu阳性组患者精液中抗精子抗体阳性率是68％，明显高于解脲支原体Uu阴性组患者精液中抗精子抗体阳性率16．1％（P〈O．01）。结论：男性生殖道解脲支原体Uu感染与精液中抗精子抗体的产生有相关性，对男性生育有不良影响。     

男性不育症患者血清抗精子抗体与精子质量的关系

目的 观察抗精子抗体(AsAb)对男性不育症患者精子质量的影响及临床意义.方法 男性不育患者553例检测血清AsAb和精液后分为两组,一组为AsAb阳性组(140例),另一组为AsAb阴性组(413例).统计两组患者精液精子密度、活率及活力的指标,两组间进行比较,观察它们之间的差异.同时取正常生育男性60例作为对照组,男性不育AsAb阳性组与正常生育组进行比较,观察它们之间的差异.结果 男性不育症553例血清AsAb检测有3种结果:抗体阴性413例(占74.7％)、精子凝集抗体(TAT)阳性122例(占22.1％)、精子凝集抗体+精子制动抗体(TAT+SIT)阳性1 8例(占3.2％);无单独精子制动抗体SIT检出.男性不育AsAb阳性组与阴性组、正常生育组精子质量经统计学比较,精子密度、活率、活力差异均有统计学意义(P＜0.05).结论 抗精子抗体检测在免疫性不育诊断和治疗中具有临床意义和参考价值.     

抗精子抗体对精子顶体酶活性的影响

目的：观察抗精子抗体对精子顶体酶活性的影响。方法：选择男性不育者５０例，与正常生育者２０例。采用固相酶染色法测抗精子抗体，固定明胶薄膜法测精子顶体酶活性。结果：５０例不育者抗精子抗体阳性率为５２％。不育者精子顶体酶活性明显低于生育者；抗精子抗体阳性者顶体酶活性低于阴性者。结论：抗精子抗体可降低精子顶体酶活性。     

抗精子抗体对生育的影响

抗精子抗体对生育的影响９０年代世界卫生组织（ＷＨＯ）报告大概有３％的不育患者是由免疫因素引起的，在１０％不育男性的血清和（或）精浆中可以发现抗精子抗体，在不育妇女血清和（或）宫颈粘液中也可能存在着抗精子抗体。抗精子抗体对精子的产生、精子的运动能力、精...     

抗精子抗体与不孕不育症及习惯性流产的关系

报道了近3年来我们对正常人、不孕不育症和习惯性流产患者的抗精子抗体的检测情况。结果发现:41名正常男性抗精子抗体均为阴性;初次来我所进行抗精子抗体检测的676名男女不孕不育症患者中,约16％的男性患者和29％的女性患者体内有抗精子抗体;其中276对不孕症夫妇,双方均为抗精子抗体阳性的约占8％,仅女方抗体阳性的约占20％,仅男方抗体阳性的约占7％。女方抗精子抗体发生率较男方为高,强阳性者也较多。结果表明抗精子抗体等免疫学因素确实是不孕症的病因之一。另外对162对习惯性流产患者及其丈夫进行了抗精子抗体检测,结果发现约2％的患者和12％患者的丈夫体内有抗精子抗体。但是与不孕症患者相比,习惯性流产患者中抗精子抗体强阳性者明显减少。     

抗精子抗体对精子顶体酶活性的影响

目的；观察抗精子抗体对精子顶体酶活性的影响。方法：选择男性不育者５０例，与正常生育者２０例。采用固相酶染色法测搞精子抗体，固定明胶薄膜法测精子顶体酶活性。结果：５０例不育者抗精子抗体阳性率为５２５，不育者精子顶体酶生明显低于生育者；抗精子抗体阳怀者顶体酶活性低于阴性者。结论：抗精子抗体可降低精子顶体酶活性。     

Exploratory Scrototomy in 168 Azoospermic Males

Summary— In 168 azoospermic males with normal or only slightly raised serum FSH levels, serum antisperm antibodies were measured, and the site of obstruction or the nature of the failure of spermatogenesis was defined by exploratory scrototomy with inspection of epididymes, vasography and testicular biopsy. When possible, surgical reconstruction was done by side-to-side epididymovasostomy, with vasovasostomy when necessary using 6/0 Prolene and no splints. Acquired blocks of cauda epididymis (34 cases) and vas (23 cases) were significantly more commonly associated with serum antisperm antibodies than congenital bilateral absence of vasa (29 cases) or blocks at the caput epididymis (48 cases), most of which were associated with sinusitis, bronchitis or bronchiectasis (Young's syndrome). Many of the former patients came from abroad, whereas most of the latter came from the British Isles. Sperm counts of 10 million per ml or more were produced by 23 (45%) of 51 adequately followed up patients with acquired blocks following surgical reconstruction, and 11 pregnancies (21.5%) were produced. Amongst those with spermatozoa in the ejaculate after surgery, serum antisperm antibodies were found significantly less often in those whose wives became pregnant compared with those who failed to produce pregnancies. It is concluded that failure of surgical treatment in some of these cases may have an immunological basis. No success was achieved with other groups.     

上海市夫妇婚后15个月时避孕知识状况及影响因素的分析

目的 :了解夫妇各自于婚礼后 1 5个月时避孕知识状况及影响因素。比较影响双方该时点避孕知识得分的因素。方法 :对上海市近 80 0 0对初婚夫妇自办婚礼后进行 2次随访。由拟合多元线性回归模型比较影响因素。结果 :该时点平均避孕知识得分妻子略高于丈夫 ,平均分别为 1 1 .7及 9.9分 ;对避孕措施一无所知分别为 1 .4%及 6.2 % ;对避孕套一无所知分别为 4.8%及 6.3 %。虽 98%的妻子及 81 %的丈夫知晓口服药 ,但能正确讲述其使用方法仅分别为 1 9%及 1 1 % ;分别有 44 %及 3 0 %未能正确掌握使用避孕套。多元回归模型显示 ,该时点夫妇避孕知识主要来自配偶、自我阅读或家庭内环境的改变。不愿服药或对避孕措施持否定态度的妻子其得分明显偏低。而新婚是否曾用避孕措施或多数性行为仅影响丈夫的得分。结论 :妻子产后近期对避孕措施的了解相对较丈夫被动。计划生育人员及社会媒体有必要消除夫妇对口服避孕药认识的误区 ,指导做好知情选择     

Effect of antisperm antibodies on postcoital results and effect of intrauterine insemination on pregnancy outcome.

The effect of antisperm antibodies (ASA) in males was determined in 59 men using the direct immunobead test (IBT). Postcoital tests were evaluated in couples for whom all female factors appeared to be corrected. Pregnancy rates in 6 months were compared in couples with good postcoital tests vs. those with poor results; the latter group was treated with timed intrauterine insemination (IUI). Thirty-one percent of males with positive ASA (greater than or equal to 50%) had normal postcoital tests and all four achieved pregnancies. Fifty-six percent of men with positive ASA and poor postcoital scores achieved pregnancies following IUI therapy of their wives in 6 months; 83% of couples with normal postcoital tests achieved pregnancies as did couples treated with IUI when the postcoital was poor but the male ASA negative.     

Proteomic identification of sperm antigens using serum samples from individuals with and without antisperm antibodies

The aim of the study was to identify human sperm antigens reacting with polyclonal antisperm antibodies. Protein sperm extracts were subjected to electrofocusing, and next immune reactions (immunoblotting) were carried out with positive for antisperm antibodies and control (not containing antisperm antibodies) serum samples. Proteomic analysis of human sperm proteins resulted in identification of 80 sperm antigens that could be divided into three groups: antigens specific for patients with antisperm antibodies (32), antigens recognised by both infertile patients and control sera (35) and antigens detected by control serum samples only (13). Among antigens specific for infertile patients, there were 12 sperm entities known to be involved in fertilisation process. We have also characterised three protein entities identified only by sera of infertile women. Altogether, the proteomic analysis resulted in identification of 27 sperm entities not reported previously in human sperm proteome. Identified proteins are sperm antigens that could be potentially responsible for immunological infertility. The study also sheds new light on the sperm antigens in aspect of gender specificity. The investigation of human sperm proteome by the use of antisperm antibodies‐containing sera of infertile individuals not only may indicate new proteins but also can draft their immunological nature.     

Etiology of severe asthenozoospermia and fertility prognosis. A screening of 5216 semen analyses

A review of n = 5216 semen analyses performed in our two Clinics from January 1986 to December 1989 allowed to identify n = 35 patients whose sperm had constantly very low motility (less than 5% progressive motile gametes in three subsequent analyses; necrozoospermia cases were excluded from this study). This apparently rare but severe anomaly was found to be associated not only with ultrastructural anomalies (n = 18), but also with positive seminal bacteriology (n = 8) or the presence of antisperm antibodies (n = 2). In eight cases the cause(s) for this constant asthenozoospermia remained obscure. The fertility potential of the men affected was followed-up and is discussed in relation to their anamnesis, physical exam and seminal characteristics.     

The clinical significance of antisperm antibodies in male subfertility.

Sera from 591 men attending Fertility Clinics have been tested for agglutinating, immobilising and immunofluorescent antisperm antibodies. There was good correlation between the presence of high titres (more than 1/32) of agglutinating and immobilising antibodies which were found in 50 patients (8.5%). 27 of these men had normal sperm counts, but crossed hostility testing showed that in 21 of 22 couples the sperms were unable to penetrate the cervical mucus, apparently because of the antibodies. 17 patients were treated with prednisone for an average of 6 months and 1 pregnancy was produced. 17 patients were treated with methylprednisolone for 7 days and 1 pregnancy resulted. No correlation was found between the present of immunofluorescent antibodies and the other antibodies of impaired sperm penetration of cervical mucus.     

The relationship of circulating antisperm antibodies to sperm surface antibodies in infertile men

The correlation between the amount and location of antisperm antibody binding to the sperm surface and the level measured in the serum has not been previously reported. Hence, the value and limitations of screening blood sera from men with suspected immunologic infertility are not currently known. In this study 70 paired sera and semen samples were assayed by the immunobead test (IBT). A screening protocol for blood sera was constructed to be 100% sensitive for detecting semen specimens with 20% or more of sperm binding IgG or IgA immunobeads. The specificity of this screening protocol was determined to be 79%. Serum IgA was not a good predictor of IgA on the sperm surface. The true positive predictive rate for antisperm antibodies on the sperm surface using circulating antisperm antibodies as a screening assay was estimated to be as low as 35%. There was little correlation between the site of immunobead binding following passive antibody transfer from patients' sera to donor sperm and the site of naturally occurring antibodies on the patients' sperm surface. Although direct assessment of antibodies on the sperm surface is preferred, these data suggest that serum IgG alone can be used as a sensitive screening assay for antisperm antibodies in men. A positive screen dictates that a direct assay on semen should be performed.     

A new method for isolation of human antisperm antibodies

Summary. A study was undertaken to isolate pure human antisperm antibodies from the sera of infertile couples. One hundred infertile couples attending the Infertility and IVF Unit (Beilinson Medical Center) because of unexplained infertility were tested (both partners) for antisperm antibodies. Sixty-eight experiments were performed with positive sera containing antisperm antibodies and normal donor sperm. These experiments were followed by experiments in order to elute pure human antisperm antibodies from the sperm surface. Three experiments were performed with human sperm which were found to be coated by antisperm antibodies, in order to directly elute these antibodies from the sperm surface. In all experiments we eluted antisperm antibodies of the IgG and IgA isotypes from the sperm surface. These antibodies were demonstrated in the eluate, in each case by either the indirect immunobead test, the radial immune diffusion assay, or the electrophoresis method. Control experiments were performed as follows: (i) normal donor sperm incubated with normal serum; (ii) normal donor sperm without serum incubation; (iii) normal donor lymphocytes incubated with serum containing antisperm antibodies; (iv) normal donor lymphocytes without serum incubation. No antisperm antibodies were obtained in any of these control experiments. Absorption and elution experiments can be used for the isolation of pure human antisperm antibodies, which may then be used for the production of anti-idiotypic antibodies to antisperm antibodies. The anti-idiotypic antibodies could be further utilized as antigen substitutes for the production of a contraceptive vaccine and/or for application in the treatment of spontaneous abortion and infertility.     

Incidence of sperm-associated immunoglobulins in infertile men with suspected autoimmunity to sperm

Semen samples from 120 infertile men with suspected autoimmunity to sperm were investigated by a direct immunobead test (IBT). Fifty-three (44%) of them had 10% or more motile sperm coated with anti-IgG and/or anti-IgA immunobeads. Both classes of immunoglobulins were found to be present in 88.7% of the antibody positive ejaculates. These sperm-bound Igs were associated with sperm autoagglutination in 80% of the ejaculates and with decreased sperm penetration into cervical mucus in 97.6% of the cases. The close correlation found between the IBT results and the occurrence of antisperm antibodies in serum and in seminal plasma suggests that sperm-bound Ig's are sperm-specific antibodies. It is concluded that the direct IBT is not only a reliable screening test for sperm antibodies but is also a relevant test to determine whether these antibodies exert an influence on male fertility.