Prevalence of anti-sperm antibodies, risk factors associated and their impact on spermatobioscopy in infertile men
Keywords:Anti-sperm antibody, Chronic prostatitis, Infection, Inflammation, Male infertility, MAR test, Seminal parameters, Varicocelectomy
Background: The first immunological correlation with male infertility was reported in 1954 by Wilson and Rumke with the identification of anti-sperm antibodies. The prevalence of anti-sperm antibodies in infertile men varies from 9%-36%, the main cause being the loss of the blood-testicular barrier and otherwise the association with chronic inflammation. It has been shown that immune infertility is found in 15% of patients with varicocele.
Methods: A transversal comparative study was carried out with 360 infertile men who were tested for anti-sperm antibodies between January 2011 and July 2018. Two groups were integrated; Group 1, infertile men with positive anti-sperm antibodies >50%, group 2, infertile men with negative anti-sperm <50%. Seminogram parameters were evaluated according to the WHO 5th edition and associated risk factors with anti-sperm antibodies.
Results: 360 infertile men were evaluated during the study, 42 were excluded because they did not meet the inclusion criteria, the prevalence of anti-sperm antibodies was 14.5%. Group 1; n=46 (14.5%) and group 2, n=272 (85.5%), the clinical characteristics and the hormonal profile were compared at study admission without significant difference. There was a significant decrease in progressive motility in group 1 (38.7±23.8) vs group 2 (50.1±18.9) p=0.03. Analyzing the risk factors, varicocele was found to be significant 23.7%, OR 2.14 (1.27-3.61) p=0.004 as well as retractable testicle 26.4%, OR 2.13 (1.23-3.70) p= 0.008.
Conclusions: The affectation of motility was confirmed, which leads to the suspect varicocele and retractable testicle as risk factors.
Zhao Y, Zhao E, Zhang C, Zhang H. Study of the changes of acrosomal enzyme, nitric oxide synthase, and superoxide dismutase of infertile patients with positive antisperm antibody in seminal plasma. Cell Biochem Biophys. 2015;73(3):639-42.
Vazquez‐Levin MH, Marín‐Briggiler CI, Veaute C. Antisperm antibodies: invaluable tools toward the identification of sperm proteins involved in fertilization. Am J Reprod Immunol. 2014;72(2):206-18.
Jiang Y, Cui D, Du Y, Lu J, Yang L, Li J, et al. Association of anti-sperm antibodies with chronic prostatitis: a systematic review and meta-analysis. J Reprod Immunol. 2016;118:85-91.
Garcia PC, Rubio EM, Pereira OC. Antisperm antibodies in infertile men and their correlation with seminal parameters. Reprod Med Biol. 2007;6(1):33-8.
Rossato M, Galeazzi C, Ferigo M, Foresta C. Antisperm antibodies modify plasma membrane functional integrity and inhibit osmosensitive calcium influx in human sperm. Hum Reprod. 2004;19(8):1816-20.
Verón GL, Molina RI, Tissera AD, Estofan GM, Marín‐Briggiler CI, Vazquez‐Levin MH. Incidence of sperm surface autoantibodies and relationship with routine semen parameters and sperm kinematics. Am J Reprod Immunol. 2016;76(1):59-69.
Cui D, Han G, Shang Y, Liu C, Xia L, Li L, et al. Antisperm antibodies in infertile men and their effect on semen parameters: a systematic review and meta-analysis. Clinica Chimica Acta. 2015;444:29-36.
Cooper TG, Noonan E, Von Eckardstein S, Auger J, Baker HW, Behre HM, et al. World Health Organization reference values for human semen characteristics. Hum Reprod Update. 2010;16(3):231-45.
Flickinger CJ, Howards SS, Bush LA, Baker LA, Herr JC. Temporal recognition of sperm autoantigens by IgM and IgG autoantibodies after vasectomy and vasovasostomy. J Reprod Immunol. 1994;27(2):135-50.
Abshagen K, Behre HM, Cooper TG, Nieschlag E. Influence of sperm surface antibodies on spontaneous pregnancy rates. Fertil Steril. 1998;70(2):355-6.
Francavilla F, Barbonetti A. Male autoimmune infertility. In Immune Infertility. 2017:187-96. Springer, Cham.
Lähteenmäki A, Reima I, Hovatta O. Treatment of severe male immunological infertility by intracytoplasmic sperm injection. Hum Reprod. 1995;10(11):2824-8.
Check JH, Aly J. Sperm antibodies and assisted reproduction. In Immune Infertility. 2017:223-34. Springer, Cham.
Collins JA, Burrows EA, Yeo J, YoungLai EV. Frequency and predictive value of antisperm antibodies among infertile couples. Hum Reprod. 1993;8(4):592-8.
Leushuis E, van der Steeg JW, Steures P, Repping S, Schöls W, van der Veen F, et al. Immunoglobulin G antisperm antibodies and prediction of spontaneous pregnancy. Fertil Steril. 2009;92(5):1659-65.
Marconi M, Nowotny A, Pantke P, Diemer T, Weidner W. Antisperm antibodies detected by mixed agglutination reaction and immunobead test are not associated with chronic inflammation and infection of the seminal tract. Andrologia. 2008;40(4):227-34.
Bonyadi MR, Madaen SK, Saghafi M. Effects of varicocelectomy on anti-sperm antibody in patients with varicocele. J Reprod Infertil. 2013;14(2):73-8.
Sinisi AA, Pasquali D, Papparella A, Valente A, Orio F, Esposito D, et al. Antisperm antibodies in cryptorchidism before and after surgery. J Urol. 1998;160(5):1834-7.
Marconi M, Weidner W. Site and risk factors of antisperm antibodies production in the male population. In Immune Infertility. 2017:133-47. Springer, Cham.
Jiang H, Zhu WJ. Cryptorchidism is not a risk factor for antisperm antibody production in post-orchidopexy males with infertility. Urol Int. 2013;90(4):470-4.