Immune infertility in men

Anti-sperm antibodies are responsible for some causes of male factor infertility. ICSI appears to be the most reliable method by which to overcome fertility impairment due to anti-sperm antibodies.
Immune infertility in men

VOLUME 117, ISSUE 6, P1121-1131

Authors:

Sebastian Leathersich, M.P.H., Roger J. Hart, M.D. 

Abstract:

Male factors are implicated as the cause of roughly half of cases of infertility, and the presence of antisperm antibodies (ASA) may be responsible for some of these. Their presence is associated with a reduction in natural conception and live birth and impacts the success of assisted reproductive technologies. Interpretation of the data regarding ASAs and fertility is complicated by a lack of standardization in testing methodology and test thresholds and a lack of data on their prevalence in the healthy fertile population. Although their pathogenesis remains elusive, and many cases are idiopathic, a disruption in the immunologic blood-testis barrier (BTB) appears to contribute to the formation of ASA. As delineation of the specific antigen targets of ASA advances, it has been recognized that they may affect almost all aspects of sperm function, and ASA against different targets likely have specific mechanisms of impairing fertility. Intracytoplasmic sperm injection (ICSI) appears to be the most reliable method by which to overcome fertility impairment due to ASA, achieving similar outcomes to ASA-negative patients with regard to fertilization rates, embryonic development, clinical pregnancy rates, and live birth rates. The lack of consistency in testing for and reporting ASA remains a substantial barrier to achieving clarity in describing their role in infertility and the optimal management approach, and future research should use a unified approach to the detection and description of ASA. Determination of the specific antigens targeted by ASA, and their function and clinical relevance, would contribute to improving the understanding of ASA-mediated impacts on fertility and tailoring treatment appropriately to achieve the best outcomes for patients.

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Comments

Go to the profile of Pandiyan  Natarajan
about 2 months ago

Immune Infertility is a Black Box.

Immunology and Genetics certainly play a crucial role in Infertility, particularly Male Infertility.  (1) However, the precise clinical role of Immunology, if any, in Male Infertility is not clear. Attempts to implicate Anti sperm Antibodies in Male Infertility have been uniformly unsuccessful. Many of us, Infertility practitioners no longer test for Anti sperm Antibodies.

Fertility and Sterility carried a lead article by Nancy Alexander, a few decades back, on Ant Sperm Antibodies- Victory or Voodoo. (2) We have found in our practice these Tests to be of no clinical significance. On the contrary, Testing and Treating Anti Sperm Antibodies could be harmful.

While Immune Infertility remains an interesting topic for research, it currently has no clinical significance. 

1. Immune Mediated Male Infertility
Dr. Shah Dupesh Khan, Dr. N.Pandiyan.

https://www.chcmj.ac.in/pdf/vol2_no2/immune_mediated.pdf

2. Treatment for antisperm antibodies: voodoo or victory?  NJ Alexander

https://www.fertstert.org/article/S0015-0282(16)53449-9/fulltext

Professor Dr Pandiyan Natarajan.

Chief Consultant in Andrology and Reproductive Sciences,

Apollo 24/7, NOVA IVF FERTILITY,

Chettinad Super Speciality Hospital (Retired).

Los Angeles, Cary, USA, Chennai, India