Antisperm Antibodies and Prostatitis???
MiamiNiceShyGuy
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
http://www.fertilitynetwork.com/articles/articles-immunological.htm
MiamiNiceShyGuy
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Echography in prostatitis
Vespasiani G; Virgili G; Giurioli A; Di Stasi SM Torelli F; Valitutti M
In many infertile patients abnormalities in sperm are due to prostatic
inflammatory disease. In the male reproductive system temporary episodes of
inflammation, caused by newly discovered micro-organisms such as chlamydia
trachomatis and ureaplasma urealyticum, may occur frequently and cause
sub-clinical inflammation. This rapidly became chronic and induce the
development of anti-spermatozoon antibodies. This latent clinical pattern and
lack of symptoms often means diagnosis is late and medical treatment
inadequate.