What are Antisperm Antibodies
Antisperm antibodies (ASA) are immune system proteins that may develop in the body of men or women to target and kill sperms. This condition is also known as immunological infertility and may make it impossible for couples to have a child.
Men generally develop antisperm antibodies from inflammatory conditions of the reproductive tract. About 8-10% of men develop the autoimmune condition in the blood or seminal fluid after a prostate infection, exposure to heavy metals, torsion, testicular cancer, vasectomy, or injury to the testicles. Scientists also suggest that oxidative stress may be a cause underlying immune infertility.
Women may develop resistance to sperm in response to an allergic reaction to semen. If this occurs, the immune system cells in the woman’s vagina may identify sperm as invaders and trigger an immune response against them.
Detecting Antisperm Antibodies
Antisperm antibodies may be antisperm agglutinating antibodies (cause the sperm to clump) or antisperm immobilizing antibodies (affect sperm motility, either completely or prevent forward progression such that sperm only shows a shaking movement (non-progressive motility)).
ASA tests may be direct or indirect. Direct ASA testing evaluates the semen for antibodies that may cause infertility. Indirect testing involves testing for antibodies in blood serum.
Antisperm antibody tests detect antibodies that may be attacking sperm in the blood, semen, or vaginal discharge. Men are advised to collect the semen sample after two days and no more than five days have elapsed following the last ejaculation. Results are generally available within 24 to 36 hours.
Clinical tests available to diagnose ASA include mixed agglutination reaction (MAR), direct immunobead test (DIT), indirect MAR or IBT, sperm immobilization test (SIT), tray agglutination test (TAT), flow cytometry, and ELISA.
Antisperm Antibodies and Male Infertility
Antisperm antibodies adversely affect certain sperm parameters. ASA may lead to a decline in sperm motility (movement and activity), liquefaction time (time taken for sperm to become liquid), and sperm concentration (number of million sperm per milliliter of semen). However, they may not necessarily affect sperm volume or morphology.
According to findings from scientific research, ASA also affects testosterone levels in men as the seminal fluid and serum of infertile men contains lower testosterone levels.
Further, ASA may cause a premature acrosome reaction in infertile men with immunological infertility, rendering the sperm incapable of fusing with the oocyte. They may also lead to subtle DNA damage that may not be corrected by the DNA repair mechanism.
Treatment Options for Antisperm Antibodies
Treatment options for antisperm antibodies are limited. Men who have developed the condition may be advised to take medication that lowers their immune response. Treatment with cyclosporine or corticosteroids is generally the chosen course of treatment.
Physicians mostly advise assisted reproductive techniques such as gamete intrafallopian transfer, intrauterine insemination (IUI), intracytoplasmic sperm injection (ICSI), or in vitro fertilization (IVF). Other laboratory techniques that resolve the condition include immunomagnetic sperm separation, sperm washing, immunobeads, and proteolytic enzyme treatment. Treatment techniques are highly variable and may differ in terms of costs and efficacy. Therefore, couples must acquire adequate information about the method, its side effects, and the expected results of their chosen treatment.
