Antisperm Antibodies

Normally, our bodies develop antibodies to help protect our immune system against illnesses. However, sometimes our bodies develop antibodies to the wrong thing, which can cause negative repercussions. Among infertile men, about 10% will be diagnosed with having antisperm antibodies, a condition that can significantly decrease your chances of pregnancy.

Immune Overdrive

Normally, the testes contain a natural barrier, known as the blood-testes barrier. This barrier acts 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.

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.

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. However, 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% unexplained infertility cases.

Sperm that does manage to make it to the egg can have a difficult time properly binding and fertilizing the egg due to antibodies attached to its head.

Reason for Antisperm Antibodies

There are numerous reasons why the natural barrier between sperm and the immune system can be broken causing antisperm antibodies to form. Some of these factors include:

  • Injury to the testicles

  • Undescended testicles

  • Twisting of the testicles

  • Infection

  • Testicular cancer

  • Testicular biopsy

  • CAVD

  • Varicocele

Additionally, men who have undergone a vasectomy reversal are particularly prone to developing this fertility problem. Close to 70% of men who have had their vasectomy reversed will develop antisperm antibodies.

Treating Antisperm Antibodies

Detecting 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.

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, thereby making this solution less desirable. Women who have antisperm antibodies may be prescribed medications to suppress their immune system.

Assisted reproductive techniques have been found to be the most helpful for couples suffering from this problem. 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.

Overall, though,IVF has proven to be the most helpful method in helping couples with antisperm antibodies conceive. Again, washing sperm beforehand is often helpful. HOwever, in some cases, it may be necessary to incorporate ICSI into the treatment as well. 

Antisperm Antibodies: How common are they?

   

Sperm are relatively protected from the immune system by a natural protective mechanism called the blood-testes barrier. Tight connections between the cells lining the male reproductive tract keep immune cells from gaining entry to the sperm within. If an injury breaches this barrier, then the immune system has access to sperm and antibodies are formed.

Antisperm antibodies have been reported in approximately 10% of infertile men, compared to less than 1% of fertile men. The prevalence of antibodies jumps dramatically in men who have had surgery on their reproductive tract: nearly 70% of men who have undergone a vasectomy reversal will have antibodies present on their sperm. Women have a much lower chance for developing antibodies to sperm: less than 5% of infertile women can be shown to have antisperm antibodies, and it is unclear who is at risk for their formation.

Who is at risk for Antisperm Antibodies?

    

Anything that disrupts the normal blood-testes barrier can result in the formation of antisperm antibodies. This may include any of the following conditions:

  • Vasectomy reversal

  • Varicocele (dilation of the veins surrounding the spermatic cord)

  • Testicular torsion (twisting of the testicle)

  • Congenital absence of the vas deferens

  • Testicular biopsy

  • Cryptorchidism (failure of testicular descent)

  • Testicular cancer

  • Infection (orchitis, prostatitis)

  • Inguinal hernia repair prior to puberty

Fortunately, intrauterine insemination (the placement of washed sperm into the uterine cavity - a common fertility treatment) has not been shown to cause antisperm antibody formation.

Despite the long list of risk factors, most men with antisperm antibodies have not had any of the conditions listed above. Therefore all infertile men are potentially at risk, and consideration should be given to testing infertile men for antisperm antibodies, especially if no other reasons for the infertility have been detected by the diagnostic workup.

How do antisperm antibodies cause infertility?

Antibodies that attach to the sperm may impair motility and make it harder for them to penetrate the cervical mucus and gain entrance to the egg; they may also cause the sperm to clump together, which is occasionally noted on a routine semen analysis. Antibodies may also interfere with the ability of the sperm to fertilize the egg.

What is the best way to detect antisperm antibodies?

Over the years, many tests have been developed to detect antisperm antibodies. In women, blood tests for antisperm antibodies in women may be more practical than trying to measure antibodies in the cervical mucus, which is the primary site where her immune system interacts with sperm. The postcoital test, which has been a standard part of the infertility evaluation, may suggest the presence of antisperm antibodies. By examining the cervical mucus following intercourse near the time of ovulation, antisperm antibodies may result in either a lack of sperm or in the presence of sperm, which are shaking in place rather than actively swimming through the mucus.

In men, a direct examination of their sperm for attached antibodies is more reliable than testing blood for the presence of antibodies. Two commonly used tests are the immunobead assay and the mixed agglutination reaction (MAR). Both tests use antibodies bound to a small marker, such as plastic beads or red blood cells, which will attach to sperm that have antibodies on their surface. The results are read as a percentage of sperm bound by antibodies.

What treatments are available for Antisperm Antibodies?

Suppressing the immune system with corticosteroids may decrease the production of antibodies but can result in serious side effects, including severe damage to the hipbone. Intrauterine insemination, with or without the use of fertility medications, has been used for the treatment of antisperm antibodies. It is believed to work by delivering the sperm directly into the uterus and fallopian tubes, thus bypassing the cervical mucus.

In vitro fertilization appears to be the most effective treatment for antisperm antibodies, especially when there are very high levels of antibodies (near 100% of sperm are bound by antibodies). There is no clear guidance on whether intracytoplasmic sperm injection (ICSI), the direct fertilization of an egg with a single sperm, is required for the treatment of antisperm antibodies, unless there had been a complete absence of fertilization on a prior attempt at in vitro fertilization.

Are there other antibodies that affect fertility?

For women with recurrent miscarriage, there are a group of antibodies that appear to attack an early developing pregnancy, resulting in either a miscarriage or severe preeclampsia with risk of intrauterine growth retardation or even fetal death. Collectively these belong to a class of antibodies known as antiphospholipid antibodies, which include the lupus anticoagulant and the anticardiolipin antibody. Testing for these antibodies are an integral part of the workup for recurrent pregnancy loss. However, it is unclear whether these antibodies play any role in the ability to conceive. Some physicians believe that the presence of antiphospholipid antibodies may decrease the chance for pregnancy through in vitro fertilization. Although this is a controversial subject, one of the largest studies that looked for these antibodies in women undergoing in vitro fertilization found that these antibodies were no more likely to be detected in those who did not become pregnant as in women who did conceive. 

Anti-sperm Antibody Testing

What are Antisperm Antibodies?

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.

Some of these factors include:

  • Injury to the testicles

  • Undescended testicles

  • Twisting of the testicles

  • Infection such as testiculitis

  • Testicular cancer

  • Testicular biopsy

  • Varicocele associated with hestasis to the testes

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.

Treatment

Treatment for Antisperm Antibodies by Dr. &  Hakeem Tariq Mehmood Taseer

Pure herbal treatment by Dr & Hakeem Tariq Mehmood Taseer to cure Antisperm antibodies problem in males with well proven results. Has a very high success rate in treating different causes of this problem. Dosage and duration of the treatment may vary as per the patient profile. Treatment is without any side effects.