Causes of Immune Infertility in Men with Anti-sperm Antibody (ASA)

Abstract

AbstractThe presence of anti-sperm antibodies (ASAs) in men can reduce fertility as similar as that in women. However, the association between the presence of ASA in men and infertility continues to be disputed, in part because a standardized and universally accepted assay for the detection of ASA, a consensus about the clinical consequences of ASA, and a mechanistic explanation of how ASA impairs conception in infertile men remain to be unestablished.As for the effect on sperm motility by ASA bound to sperm surface, there exists significant inhibitory effect of sperm-immobilizing antibodies in ejaculated human sperm on sperm motility in immunologically infertile men.ASAs bound to sperm surface in infertile men also show significant inhibitory effect on sperm passage through cervical mucus (CM). However, it was also proved by our study that the ability of sperm passage through CM is not inhibited in two-fifths of men with ASA. It indicates there is a diversity of ASA bound to sperm surface in infertile men.It has been shown that ASAs in men have an inhibitory effect on fertilization. However, others have arrived at the opposite conclusion. These results also indicate that there is a diversity of the blocking effects on fertilization by ASA bound to sperm surface. It has been also shown that ICSI demonstrates comparable fertilization, pregnancy, implantation, and miscarriage rates in female partners of men with and without ASA.Based on our study, a sperm-zona pellucida binding assay such as the hemizona assay (HZA) should be performed for appropriate decision-making in infertile men with ASA.