What does the term anti-sperm antibody mean? We turned to the team at Clinica Tambre to explain.
What is an antisperm antibody?
Anti-sperm antibodies are proteins synthesized by our own immune system against spermatozoa that are identified as foreign elements due to a break or injury in the hematotesticular barrier. Their presence in the ejaculate can lead to male infertility.
Is this different to natural killer cells?
Anti-sperm antibodies are immunoglobulins of the IgA and IgG type that are produced by B lymphocytes and plasma cells that collaborate with the body’s defense. While Natural Killer (NK) cells are another type of lymphocyte, whose mechanism of action is cellular cytotoxicity.
How do you know if you have anti sperm bodies?
The performance of a simple semen quality test is sufficient to know whether or not there are indications of the presence of anti-sperm antibodies in the semen due to the observation of sperm agglutination. The subsequent use of specific tests can confirm the affectation and degree of affectation of this pathology.
Is this something that affects men or women?
The appearance of anti-sperm antibodies can be observed in both men and women, although their affectation and origin are different.
How do you test anti-sperm antibodies?
For the diagnosis of anti-sperm antibodies, there are several techniques that detect the presence of these antibodies in biological fluids, either semen or cervical mucus (in women after intercourse). The methods used are based on the determination of the antibodies in the semen, and are:
MAR-test IgA: It consists of mixing a small volume of semen with a medium containing latex pellets that present specific antibodies that detect IgA-type anti-sperm antibodies. When the union of the pellets with these anti-sperm antibodies takes place, agglutination of the spermatozoa joined to the latex pellets is observed under the phase contrast microscope. Depending on the number of spermatozoa attached to these pellets, a (positive/negative) result is obtained.
Immunobeads: It is used to detect both IgG and IgA type anti-sperm antibodies, as well as to locate them in the head and/or tail of the sperm. Its methodology is based on acrylamide particles coated with specific anti-globulins. This technique is more expensive and laborious than the previous one.
Will I be tested for this before I start a round of IVF? Is this test expensive?
The performance of a basic seminogram is one of the essential tests that are always requested at the beginning of any assisted reproduction treatment. Based on these results, if the presence of agglutinated sperm populations is observed, an additional test would be required for their detection and quantification. In our case, we would perform a MAR-test IgA. The price of this test will depend on the centre and the country.
What causes sperm antibodies?
The hematotesticular barrier is a cellular barrier of selective permeability present in males. When the hematotesticular barrier is broken or damaged, anti-sperm antibodies can reach the testicles and join the sperm.
Some of the most frequent causes that can cause the hematotesticular barrier to break down in males are:
Semen infections
Varicocele
Vasectomy
Testicular biopsy
Testicular torsion
In women the presence of these antibodies can also be observed (although in a smaller number), with its more frequent causes being:
Gynecological infections
Inflammations of the genital tract
In any case, the presence of these antibodies will hinder progressive sperm mobility, interfering in the correct fertilization of the oocyte.
Can you get pregnant with sperm antibodies?
The presence of anti-sperm antibodies will greatly affect sperm mobility, and consequently the rate of natural gestation, since they will prevent the sperm from reaching the uterus and the Fallopian tubes to meet the egg. In women who have been observed to have high levels of anti-sperm antibodies, there is a significant reduction in fertilization.
To increase the rate of natural gestation it is necessary to resort to drugs that can decrease the amount of these antibodies and thus restore normal gestation rates.
Another more efficient way is the application of seminal washes included in fertilization treatments, such as Intrauterine Insemination or In Vitro Fertilization.
Can I reduce my sperm antibodies?
One of the treatments used to reduce the presence of anti-sperm antibodies is the use of corticosteroids in high doses, exercising their immunosuppressive effect on the immune system. However, we must not forget the existence of several negative effects in a treatment prolonged in time due to the high doses given.
How do you get rid of sperm antibodies?
As we have commented in a previous section, seminal washing by means of different sperm selection techniques for its subsequent application in artificial insemination or in vitro fertilization will help us lower the number of anti-sperm antibodies as well as the number of sperm with mobility problems in the semen sample. However, these washings are not completely effective, and the choice of one or another assisted reproduction treatment will depend on the degree and type of affectation.
Could they return?
If we are under the effects of treatments with corticosteroids, once we abandon the treatment these antibodies will reappear. In addition, the effectiveness of these treatments and their duration is not sufficiently proven in all patients.
Is it common?
The presence of anti-sperm antibodies is estimated at around 9 to 12.8% of infertile couples. However, these antibodies are not only present in infertile males, but their presence has also been observed in fertile patients (males: 1-2.5%; females: 4%).
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