Recurrent Pregnancy Loss   : An Introduction to Categories 1 - 5 Immune Problems

 

Category 4 Immunological Problems

 

Autoimmune Response to Sperm Antigen

Ten percent of women with infertility, implantation failures and recurrent pregnancy losses have produced antibodies to sperm. When this happens, a couple is unable to conceive normally, even if they had no problems with conception in the past. The antibody to sperm is often associated with antiphospholipid antibodies to the phospholipids serine and ethanolamine. Antibodies to sperm should be suspected

  • if women have antibodies to serine and or ethanolamine,
  • in women with poor post coital tests (sperm are dead or not moving in the cervical mucus), and
  • in women whose spouses have antisperm antibodies.

Being exposed to antibody coated sperm dispensed by the male seems to encourage women to make antisperm antibodies on their own. When antisperm antibodies develop, they will inactivate or attack sperm from the husband and any donor (i.e., they are not partner specific). Testing for antisperm antibodies in women is done from a blood sample. There are more than five different methods to determine if antisperm antibodies are present. The most sensitive and reliable methods are

  1. immunobead binding antisperm antibody assay, and
  2. flow cytometry detection of antisperm antibodies.

The presence of antisperm antibodies in women strongly predicts that she will also have category 5 immune problems.

Autoimmune Response to Sperm Antigen
Autoimmune Response to Sperm Antigen

Consequences

  • Sperm antibody test positive.
  • Sperm antibody positive by flow cytometer.
  • Couple is unable to conceive normally.
  • Multiple failed pregnancy through IVF, IUI, GIFT or ZIFT.

 

 

 Consequences of Recurrent Pregnancy Loss   : An Introduction to Categories 1 - 5 Immune Problems

   

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Department of Obstetrics and Gynecology  ,   Chia-Yi Chang Gung Memorial Hospital