Normally, our bodies develop antibodies to help protect our immune system against illnesses. However, sometimes our bodies develop antibodies to the wrong thing, which can cause negative repercussions. Among infertile men, about 10% will be diagnosed with having antisperm antibodies, a condition that can significantly decrease your chances of pregnancy.
Normally, the testes contain a natural barrier, known as the blood-testes barrier. This barrier acts a protective layer that prevents immune cells from being able to access sperm within the male reproductive tract. Yet, this barrier can be broken, through injury to the reproductive tract, thereby allowing the immune cells to come into contact with the sperm.
Once the barrier is broken, immune cells are able to detect the presence of sperm due to their unique antigen surface. This triggers a response by the immune system to treat sperm as an "invader" and attack it. Antibodies then attach themselves to different parts of the sperm and interfere with male fertility in a number of ways.
Antibodies that are located on the tail of sperm can cause the sperm to become immobilized or clump together. When antibodies are found on the head of sperm, they can prevent the sperm from being able to efficiently make its way through a woman’s cervical mucus to the egg. However, it is also possible for a woman to develop antisperm antibodies in her cervical mucus, which will only serve to hinder attempts at conception even more. It is thought that antisperm antibodies in cervical mucus could account for as much as 40% unexplained infertility cases.
Sperm that does manage to make it to the egg can have a difficult time properly binding and fertilizing the egg due to antibodies attached to its head.
Reasons for Antisperm Antibodies
There are numerous reasons why the natural barrier between sperm and the immune system can be broken causing antisperm antibodies to form. Some of these factors include:
- Injury to the testicles
- Undescended testicles
- Twisting of the testicles
- Testicular cancer
- Testicular biopsy
Additionally, men who have undergone a vasectomy reversal are particularly prone to developing this fertility problem. Close to 70% of men who have had their vasectomy reversed will develop antisperm antibodies.
Treating Antisperm Antibodies
Detecting antisperm antibodies is usually fairly simple as a semen analysis should be able to identify whether the antibodies are present. It is also possible to do an individual test that looks specifically for antisperm antibodies on sperm or, in women, in cervical mucus. However, getting rid of the antibodies may not be as easy.
While the use of corticosteroids can decrease the number of antibodies, temporarily restoring fertility, it is necessary to use very high doses. These high doses often cause serious side effects, thereby making this solution less desirable. Women who have antisperm antibodies may be prescribed medications to suppress their immune system.
Assisted reproductive techniques have been found to be the most helpful for couples suffering from this problem. Some couples have found success with IUI as this involves depositing sperm directly into the uterus. This technique appears to work best in couples whose difficulties stem from the cervical mucus. Washing sperm before the procedure can also rid the sperm of most antibodies.
Overall, though,IVF has proven to be the most helpful method in helping couples with antisperm antibodies conceive. Again, washing sperm beforehand is often helpful. HOwever, in some cases, it may be necessary to incorporate ICSI into the treatment as well.