The Role of Anti-Sperm Antibodies in Primary, Secondary, Immunological and Idiopathic Infertility in Men

Abstract

The current study aimed to conduct a statistical study to find out the numbers of men with primary and secondary infertility, immunological infertility and Idiopathic infertility in the city of Tikrit with an estimate of the levels of some sex hormones and physiological and immunological variables. The study included 400 married men who attended the Urology Department at Salah Al-Din Hospital and private clinics in the city of Tikrit and its environs for the period from April 2021 to February 2022, and their ages ranged from (20-50) years, and they were divided into two main groups as follows: It included (80) men, and it was divided into four sub-groups, namely: - The group of patients with primary infertility and included 20 individuals. The group of patients with secondary infertility included 20 individuals. And the group of immunocompromised patients included 20 individuals. And the group of patients with unexplained infertility included 20 individuals. The group of natural (fertile) individuals: It is the fifth group and represents the control group, which included (20) individuals. The results showed that the percentage of primary infertility was the highest among infertile patients, reaching 41%, while the percentage was lowest for immunological infertility, reaching 7%. While the percentage of secondary and unexplained infertility was 21% and 31%, respectively. On the other hand, the results showed that there were significant differences (P<0.05) in sperm parameters between the study groups, as sperm concentrations and the percentage of mobile sperm showed a significant decrease (P<0.05), especially in the secondary infertility group compared to the control group. As for the percentage of slow-moving sperms, there were no significant changes (P<0.05) in all infertile groups compared with the control group. As for the percentage of non-motile sperms, it showed a significant increase (P<0.05), especially in the unexplained infertility group compared with the control group. With regard to sperm shape, the percentage of deformed sperm showed a significant increase (P<0.05), especially in the primary infertility group compared with the control group. The results of the current study also showed that there were significant differences (P < 0.05) in the concentrations of hormones between the study groups, as the concentrations of testosterone showed a significant decrease (P < 0.05), especially in the primary infertility group compared with the control group, while the least significant decrease was recorded (P<0.05) in testosterone concentration in the unexplained infertility group. Regarding the prolactin hormone, a significant increase (P<0.05) was recorded in the infertility groups compared with the control group, as it was significantly higher in the secondary infertility group. LH also showed significant differences (P<0.05) between the study groups, and the highest significant increase was in the primary infertility group compared to the control group, while the unexplained infertility group did not show any significant differences compared to the control group. As for the FSH hormone, it showed significant differences (P<0.05) between the study groups, as it recorded the highest significant increase in the primary infertility group compared to the control group, while the unexplained infertility group did not show any significant differences compared to the control group. The results of the current study also showed that there were significant differences (P<0.05) in the concentrations of immunoglobulins between the study groups, as the concentrations of IgA showed a significant decrease (P<0.05), especially in the secondary infertility group compared with the control group, while the least significant increase was recorded (P<0.05). 0.05) in the concentration of IgA in the immunocompromised group. Regarding IgG, a significant increase (P<0.05) was recorded in the infertile groups compared with the control group, if the highest significant increase was in the immunocompromised group. While the primary and secondary infertility group did not show any significant differences compared to the control group. IgM showed significant differences (P < 0.05) between the study groups, and the highest significant increase was in the immunocompromised infertility group compared with the control group, while the primary and secondary infertility groups did not show any significant differences compared with the control group. Also, ASA concentrations showed a significant increase (P<0.05), especially in the unexplained infertility group, while no significant change (P<0.05) was recorded in the ASA concentration in the primary infertility group. With regard to white blood cells, the percentage of white blood cells showed a significant increase (P<0.05), especially in the group of immunocompromised infertility, while the percentage of white blood cells was lowest in the group of primary infertility.