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Antisperm antibodies are immune antibodies that can inhibit sperm motility and weaken sperm fertilization ability. Antisperm antibodies include four types: IgG, IgA, IgM, and IgE. Antisperm antibodies in semen almost all belong to two types of immunoglobulins: IgA and IgG. They may exist in the serum and plasma of patients, in the cervical mucus of women, and on the surface of sperm in men. Whether men or women, the presence of antisperm antibodies in the body may lead to infertility. Under normal circumstances, there are no antisperm antibodies in men and women, but in some special cases, the female body's "self-defense" against sperm and semen antigens will cause the immune system to produce antibodies. Why do men have an immune response to their own sperm? The immune tolerance theory believes that when an effective antigen comes into contact with immune-active cells during the embryonic period, the immune-active cells against the antigen can be suppressed. Therefore, the individual no longer has an immune response to the antigen after adulthood. Since there is no sperm production during the embryonic period, sperm begins to be produced by the testicles during puberty, which is far beyond the period when the body establishes tolerance to itself. Therefore, the male body has not established immune tolerance to its own sperm. Therefore, sperm-specific antigens are self-antigens, or "hidden" antigens. Under normal circumstances, the antigenic substances of spermatogenic cells will not enter the blood circulation and cause autoimmune reactions. In certain pathological conditions, they can lead to anti-sperm immune reactions.
Figure 1. Production of antisperm antibodies and the mechanisms of action in the female reproductive tract that lead to infertility. (Sources: A S V, Dhama K, et al. 2019)
There are many reasons for the production of male anti-sperm antibodies, mainly including the following three: 1. Destruction of the blood-testis barrier; Under normal circumstances, the blood-testis barrier prevents sperm from contacting the body's immune system, becoming a hidden antigen and not causing an autoimmune response. When the blood-testis barrier is destroyed due to surgery, trauma, infection, etc., sperm leaks out or macrophages enter the reproductive tract to phagocytose and digest sperm cells. The sperm antigens they carry activate the immune system and produce anti-sperm antibodies. Common clinical causes include vasectomy, vas deferens anastomosis, vas deferens obstruction, reproductive tract injury and testicular injury. 2. Immune dysfunction; the possible cause is a decrease in the amount or activity of suppressor T lymphocytes. Under normal circumstances, a small amount of sperm antigens leaked from the blood testis and its vas deferens can activate suppressor T cells, making the process of mature B cells recognizing antigens slow, reducing the body's humoral immune response to sperm antigens, and forming immune tolerance. When the number or activity of suppressor T cells decreases and the factors that activate suppressor T cells in semen are lacking, anti-sperm antibodies can also be produced. 3. Abnormalities in seminal plasma immunosuppressive substances: Seminal plasma immunosuppressive substances can block sperm antigens, inhibit local immune responses in the reproductive tract, and have a physiological protective effect on sperm and reproductive activity. When the quality and quantity of seminal plasma immunosuppressive substances change or become abnormal, this balance can be disrupted. If the husband's semen lacks seminal plasma immunosuppressive substances, the spouse can produce anti-sperm antibodies.
The anti-sperm antibodies produced will interfere with reproduction, and the main mechanisms are: 1. Affecting sperm movement; anti-sperm antibodies bind to sperm, causing sperm agglutination, resulting in decreased sperm motility, movement obstruction, and reduced sperm survival rate. At the same time, after the sperm is bound by anti-sperm antibodies, its ability to penetrate cervical mucus is significantly inhibited. Therefore, anti-sperm antibodies can reduce the chance of pregnancy by reducing sperm motility, survival rate and inhibiting sperm from passing through cervical mucus. 2. Affecting sperm capacitation and acrosome reaction; anti-sperm antibodies can affect the activity of sperm membranes, thereby hindering or delaying capacitation. Anti-sperm antibodies can hinder sperm from releasing hyaluronidase, thereby inhibiting sperm acrosome reaction. 3. Affecting sperm passing through the zona pellucida and sperm-egg fusion; anti-sperm antibodies inhibit sperm acrosome reaction, thereby inhibiting sperm from dispersing the corona radiata and penetrating the zona pellucida, reducing sperm-egg fusion. 4. Impact on fertilized eggs; anti-sperm antibodies can interfere with the implantation of fertilized eggs, resulting in embryo absorption or miscarriage. The possible reason is that the early embryo can temporarily express various antigens during its development, some of which have cross-immunity with sperm proteins and teratomas. There are many methods for detecting anti-sperm antibodies, but there are also various shortcomings. An ideal method for detecting antibodies should meet the following conditions: 1. High sensitivity, strong specificity, and good repeatability. 2. Ability to determine the type of antibody. 3. Ability to determine the binding site of the antibody. 4. Ability to quantitatively or semi-quantitatively detect anti-sperm antibodies. The antibody titer and the binding site of the antibody on the sperm determine the extent of its damage to fertility. Anti-sperm antibodies bound to the sperm head cause greater damage to fertility, while antibodies bound to the sperm tail have less effect on fertility. Therefore, detecting antibodies on the surface of the sperm head is more practical. Anti-sperm antibody detection methods include mixed antiglobulin reaction test (MARtest), gelatin agglutination test (GAT), tissue compatibility plate agglutination test (TAT), immunobead test (IBT) and enzyme-linked immunosorbent assay (ELISA).
Spermatozoon
Spermatozoa
Sperm cell
Male gamete
References
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In vitro Development of Preimplantation Caprine Embryo using Cryopreserved Black Bengal Buck Semen
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ANDROLOGIA
Authors: Di Pizio, Pierre; Celton, Noemie; Menoud, Pierre Alain; Belloc, Stephanie; Bacrie, Martine Cohen; Belhadri-Mansouri, Naima; Rives, Nathalie; Cabry, Rosalie; Benkhalifa, Moncef
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