Immunological Factor and Infertility
Recently, there has been a lot of discussion about the role that the immune system plays in fertility. The immune system generally works to protect the body from foreign cells and bacteria. Sometimes though, problems within the immune system prevent it from working properly. Many couples facing infertility issues may actually have immune system dysfunction, which is preventing them from conceiving. Luckily, new tests are now available to pinpoint these immune factors in infertility.
What is the Immune System?
The immune system consists of a variety of cells and tissues that help to defend you against invading cells and foreign bacteria. It can recongnize the difference between your body's own cells and those cells that aren't meant to be inside of you. Without your immune system, you couldn't fight off things like illness, pain, or infection. In most people, the immune system works properly all the time. Sometimes however, the system can break down, leaving you open to illness, infection, or various autoimmune diseases.
The Immune System and Fertility
Though you may not realize it, your immune system also plays a huge role in your fertility. In order to prepare for ovulation and implantation, your body needs to use certain cells from your immune system. For instance, inflammatory cells are needed to help prepare the endometrial lining for implantation. Without a working immune system, normal reproduction cna be affected, preventing pregnancy. In fact, it is though that up to 20% of couples with unexplained infertility are actually suffering from an immune system dysfunction.
What are Antisperm Antibodies?
Antisperm antibodies are one immune factor which could be involved in infertility. Antisperm antibodies are cells that fight against normal, healthy sperm. If you have antisperm antibodies, instead of seeing sperm as natural cells, your immune system fights against your sperm and destroys them. This prevents you from producing any viable sperm. Though still to be proven, there is evidence that antibodies against sperm can result in male infertility.
How Do Antisperm Anitbodies Affect Fertility?
Antisperm antibodies can really impair the function of healthy sperm. These antibodies attach to your sperm, reducing motility and making it more difficult for sperm to pass through cervical mucus. Antisperm antibodies can also force sperm to clump together, making it difficult for your sperm to fertilize an egg.
What Causes Antisperm Antibodies?
It is not entirely known why antisperm antibodies develop in some people. Typically, sperm are protected from your immune system by a protective lining, called the blood-testes barrier. This barrier prevents cells from your immune system from getting mixed in with your sperm and killing them. Sometimes, surgery or injury can interfere with this barrier, allowing immune cells to come into contact with sperm cells.
How Common are Antisperm Antibodies?
Antisperm antibodies are actually thought to be relatively common in a certain subset of men. While only 1% of fertile men have these antibodies in their blood stream, up to 10% of infertile men have them. Men who have undergone reproductive surgery also seem to have antisperm antibodies; up to 70% of men who have had a vasectomy reversal have antisperm antibodies.
Sometimes, women can develop antisperm antibodies. About 5% of women with unexplained infertility have these antibodies in their blood stream. As a result, sperm are killed before they have chance to fertilize the egg.
Who Can Get Antisperm Antibodies?
Any man can potentially develop antisperm antibodies, as can any woman, so couples facing infertility should be tested for the antibodies. However, certain people are more at risk of developing these antibodies. Men who have experienced the following are at increased risk for developing antisperm antibodies:
- vasectomy reversal
- testicular cancer
- testicular biopsy
- varicocele
- testicular torsion
- infections
These factors increase your risk for having your blood-testes barrier compromised, which can lead to the growth of antisperm antibodies.
Testing for Antisperm Antibodies
There are a variety of tests that can detect the presence of antisperm antibodies in the body:
- Blood Tests: In women, blood tests are commonly used to detect the antibody.
- Post-Coital Test: The post-coital test can detect the presence of antisperm antibodies in a woman's cervical mucus.
- Sperm Testing: In men, sperm testing is the best way to analyze for antisperm antibodies. The immunobead assay and the mixed agglutination reaction test are both used.
Treating Antisperm Antibodies?
There are a variety of treatments available to help couples struggling with antisperm antibodies to conceive.
- Corticosteroids: Corticosteroids help to decrease the production of antisperm antibodies. Unfortunately, corticosteroids are associated with side effects, including hipbone damage.
- Intrauterine Insemination(IUI): IUI can help couples to overcome antisperm antibodies as it allows sperm to bypass the cervical mucus. Fertility drugs can also be used.
- In-Vitro Fertilization(IVF): IVF is the most successful treatment for couples with antisperm antibodies. This allows the sperm to be directly injected into the egg, without havng to travel throguh the uterus and fallopian tubes.
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