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Lu SM, Li X, Wang SL, Yang XL, Xu YZ, Huang LL, Liu JL, Cai FF, Chen ZJ. Success rates of in vitro fertilization versus intracytoplasmic sperm injection in men with serum anti-sperm antibodies: a consecutive cohort study. Asian J Androl 2020; 21:473-477. [PMID: 30719984 PMCID: PMC6732894 DOI: 10.4103/aja.aja_124_18] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Antisperm antibodies (ASAs) are assumed to be a possible causative factor for male infertility, with ASAs detected in 5%–15% of infertile men but in only 1%–2% of fertile ones. It remains unclear whether ASAs have an adverse effect on the outcome of in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI). This study investigated differences in the rates of fertilization, pregnancy, and live births associated with serum ASA-positive and ASA-negative men following IVF or ICSI. Five hundred and fifty-four consecutive infertile couples undergoing IVF (n = 399) or ICSI (n = 155) were included. The two-sample two-sided t-test and Chi-square or Fisher's exact test was used for statistical analysis. Lower rates of fertilization (41.7% vs 54.8%, P = 0.03), good embryos (18.9% vs 35.2%, P = 0.00), pregnancy (38.5% vs 59.4%, P = 0.00), and live births (25.8% vs 42.5%, P = 0.00) were observed in men of the IVF group with a positive serum ASA than in those with a negative ASA. ASA positivity/negativity correlated with pregnancy rates (P = 0.021, odds ratio [OR]: 0.630, 95% confidence interval [CI]: 0.425–0.932) and live birth rates (P = 0.010, OR: 1.409, 95% CI: 1.084–1.831) after controlling for the female serum follicle-stimulating hormone level and the couple's ages at IVF. Women coupled with ASA-positive men had lower live birth rates with IVF than with ICSI (25.8% and 47.4%, respectively; P = 0.07). Women coupled with ASA-positive men had lower rates of pregnancy and live births following IVF than those coupled with ASA-negative men but had a similar outcome with ICSI.
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Affiliation(s)
- Shao-Ming Lu
- Center for Reproductive Medicine, Shandong Provincial Hospital Affiliated to Shandong University, National Research Center for Assisted Reproductive Technology and Reproductive Genetics, The Key laboratory for Reproductive Endocrinology of Ministry of Education, Jinan 250000, China
| | - Xiao Li
- Center for Reproductive Medicine, Shandong Provincial Hospital Affiliated to Shandong University, National Research Center for Assisted Reproductive Technology and Reproductive Genetics, The Key laboratory for Reproductive Endocrinology of Ministry of Education, Jinan 250000, China
| | - Shi-Li Wang
- Maternal and Child Health Care Hospital, Rizhao 276800, China
| | - Xiao-Li Yang
- The Medical Scientific Research Center of Guangxi Medical University, Nanning 53000, China
| | - Yan-Zhen Xu
- The Medical Scientific Research Center of Guangxi Medical University, Nanning 53000, China
| | - Ling-Ling Huang
- Department of Obstetrics, The First Affiliated Hospital of Guangxi Medical University, Nanning 53000, China
| | - Jiao-Long Liu
- Center for Reproductive Medicine, Shandong Provincial Hospital Affiliated to Shandong University, National Research Center for Assisted Reproductive Technology and Reproductive Genetics, The Key laboratory for Reproductive Endocrinology of Ministry of Education, Jinan 250000, China
| | - Fei-Fei Cai
- Center for Reproductive Medicine, Shandong Provincial Hospital Affiliated to Shandong University, National Research Center for Assisted Reproductive Technology and Reproductive Genetics, The Key laboratory for Reproductive Endocrinology of Ministry of Education, Jinan 250000, China
| | - Zi-Jiang Chen
- Center for Reproductive Medicine, Shandong Provincial Hospital Affiliated to Shandong University, National Research Center for Assisted Reproductive Technology and Reproductive Genetics, The Key laboratory for Reproductive Endocrinology of Ministry of Education, Jinan 250000, China
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Bryan ER, Kim J, Beagley KW, Carey AJ. Testicular inflammation and infertility: Could chlamydial infections be contributing? Am J Reprod Immunol 2020; 84:e13286. [DOI: 10.1111/aji.13286] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Revised: 06/05/2020] [Accepted: 06/05/2020] [Indexed: 12/12/2022] Open
Affiliation(s)
- Emily R. Bryan
- School of Biomedical Sciences Institute of Health and Biomedical Innovation Queensland University of Technology Brisbane Qld Australia
| | - Jay Kim
- School of Biomedical Sciences Institute of Health and Biomedical Innovation Queensland University of Technology Brisbane Qld Australia
| | - Kenneth W. Beagley
- School of Biomedical Sciences Institute of Health and Biomedical Innovation Queensland University of Technology Brisbane Qld Australia
| | - Alison J. Carey
- School of Biomedical Sciences Institute of Health and Biomedical Innovation Queensland University of Technology Brisbane Qld Australia
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Jacobsen FM, Rudlang TM, Fode M, Østergren PB, Sønksen J, Ohl DA, Jensen CFS. The Impact of Testicular Torsion on Testicular Function. World J Mens Health 2019; 38:298-307. [PMID: 31081295 PMCID: PMC7308234 DOI: 10.5534/wjmh.190037] [Citation(s) in RCA: 50] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Accepted: 03/17/2019] [Indexed: 12/02/2022] Open
Abstract
Torsion of the spermatic cord is a urological emergency that must be treated with acute surgery. Possible long-term effects of torsion on testicular function are controversial. This review aims to address the impact of testicular torsion (TT) on the endocrine- and exocrine-function of the testis, including possible negative effects of torsion on the function of the contralateral testis. Testis tissue survival after TT is dependent on the degree and duration of TT. TT has been demonstrated to cause long-term decrease in sperm motility and reduce overall sperm counts. Reduced semen quality might be caused by ischemic damage and reperfusion injury. In contrast, most studies find endocrine parameters to be unaffected after torsion, although few report minor alterations in levels of gonadotropins and testosterone. Contralateral damage after unilateral TT has been suggested by histological abnormalities in the contralateral testis after orchiectomy of the torsed testis. The evidence is, however, limited as most human studies are small case-series. Theories as to what causes contralateral damage mainly derive from animal studies making it difficult to interpret the results in a human context. Large long-term follow-up studies are needed to clearly uncover changes in testicular function after TT and to determine the clinical impact of such changes.
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Affiliation(s)
- Frederik M Jacobsen
- Department of Urology, Herlev and Gentofte Hospital, University of Copenhagen, Herlev, Denmark.
| | - Trine M Rudlang
- Department of Urology, Herlev and Gentofte Hospital, University of Copenhagen, Herlev, Denmark
| | - Mikkel Fode
- Department of Urology, Herlev and Gentofte Hospital, University of Copenhagen, Herlev, Denmark
| | - Peter B Østergren
- Department of Urology, Herlev and Gentofte Hospital, University of Copenhagen, Herlev, Denmark
| | - Jens Sønksen
- Department of Urology, Herlev and Gentofte Hospital, University of Copenhagen, Herlev, Denmark
| | - Dana A Ohl
- Department of Urology, University of Michigan, Ann Arbor, MI, USA
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Gatimel N, Moreau J, Isus F, Moinard N, Parinaud J, Leandri RD. Anti-sperm antibodies detection by a modified MAR test: Towards a better definition of its indications. Reprod Biomed Online 2018; 37:717-723. [PMID: 30409465 DOI: 10.1016/j.rbmo.2018.09.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2018] [Revised: 09/10/2018] [Accepted: 09/19/2018] [Indexed: 11/28/2022]
Abstract
RESEARCH QUESTION Anti-sperm antibodies (ASA) have been shown to reduce male fertility but consensus about the precise situations in which tests should be carried out are lacking. In infertility investigations, should the mixed antiglobulin reaction (MAR) test be a first-line test? Should it be carried out systematically before assisted reproductive technology (ART)? What are the risk factors for ASA? DESIGN All infertile patients (n = 1364) were tested with SpermMar (modified MAR test) between July 2013 and June 2017. Intra-patient variability of the MAR test was also assesed by comparing two tests within the same year in selected patients (n = 101). RESULTS The main factor that influenced the percentage of ASA was the presence or absence of sperm agglutination. In the presence of agglutinations, 27 out of 72 (37.5%) patients were positive for ASA compared with 33 out of 1292 (2.6%) in the absence of agglutinations (P < 0.0001). When one risk factor was present (spontaneous sperm agglutination, history of scrotal trauma or inguinal surgery), 33 out of 179 (18.44%) tests were positive for ASA (≥50% coated spermatozoa), whereas only 27 out of 1242 (2.2%) were positive when no risk factor was present (P < 0.0001). CONCLUSIONS ASA detection should not be systematically recommended in investigations of fertility status and before ART but reserved for when sperm agglutination is found during conventional sperm examination, or if the patient has a history of scrotal trauma or has undergone inguinal surgery.
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Affiliation(s)
- Nicolas Gatimel
- Service de Médecine de la Reproduction, Hôpital Paule de Viguier, CHU Toulouse, 330 avenue de Grande Bretagne, Toulouse 31059, France; Université Paul Sabatier Toulouse-III, Groupe de Recherche en Fertilité Humaine (EA 31694, Human Fertility Research Group), 330 avenue de Grande Bretagne, Toulouse 31059, France.
| | - Jessika Moreau
- Service de Médecine de la Reproduction, Hôpital Paule de Viguier, CHU Toulouse, 330 avenue de Grande Bretagne, Toulouse 31059, France; Université Paul Sabatier Toulouse-III, Groupe de Recherche en Fertilité Humaine (EA 31694, Human Fertility Research Group), 330 avenue de Grande Bretagne, Toulouse 31059, France
| | - François Isus
- Service de Médecine de la Reproduction, Hôpital Paule de Viguier, CHU Toulouse, 330 avenue de Grande Bretagne, Toulouse 31059, France; Université Paul Sabatier Toulouse-III, Groupe de Recherche en Fertilité Humaine (EA 31694, Human Fertility Research Group), 330 avenue de Grande Bretagne, Toulouse 31059, France
| | - Nathalie Moinard
- Service de Médecine de la Reproduction, Hôpital Paule de Viguier, CHU Toulouse, 330 avenue de Grande Bretagne, Toulouse 31059, France; Université Paul Sabatier Toulouse-III, Groupe de Recherche en Fertilité Humaine (EA 31694, Human Fertility Research Group), 330 avenue de Grande Bretagne, Toulouse 31059, France
| | - Jean Parinaud
- Service de Médecine de la Reproduction, Hôpital Paule de Viguier, CHU Toulouse, 330 avenue de Grande Bretagne, Toulouse 31059, France; Université Paul Sabatier Toulouse-III, Groupe de Recherche en Fertilité Humaine (EA 31694, Human Fertility Research Group), 330 avenue de Grande Bretagne, Toulouse 31059, France
| | - Roger D Leandri
- Service de Médecine de la Reproduction, Hôpital Paule de Viguier, CHU Toulouse, 330 avenue de Grande Bretagne, Toulouse 31059, France; Université Paul Sabatier Toulouse-III, Groupe de Recherche en Fertilité Humaine (EA 31694, Human Fertility Research Group), 330 avenue de Grande Bretagne, Toulouse 31059, France
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Verón GL, Molina RI, Tissera AD, Estofan GM, Marín-Briggiler CI, Vazquez-Levin MH. Incidence of Sperm Surface Autoantibodies and Relationship with Routine Semen Parameters and Sperm Kinematics. Am J Reprod Immunol 2016; 76:59-69. [PMID: 27139084 DOI: 10.1111/aji.12519] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2016] [Accepted: 04/07/2016] [Indexed: 01/01/2023] Open
Abstract
PROBLEM Antisperm antibodies (ASA) are associated with male subfertility. However, results on sperm surface autoantibodies are controversial, the relationship between ASA and semen parameters (WHO, 2010) is unknown, and data on ASA and sperm kinematics are scarce. METHOD OF STUDY A retrospective study carried out in men undergoing routine semen analysis (WHO 2010), ASA evaluation (direct SpermMAR(™) (IgG) test), and computer-assisted sperm analysis (CASA). RESULTS A 2.6% and a 5.9% incidence of ASA-positive cases were found (cut-off 50% and 10%, respectively; n = 7492). ASA-positive samples had lower (P < 0.0001) sperm concentration, count, motility, and hypo-osmotic swelling (HOS) test score. HOS results did not correlate with sperm vitality in normozoospermic samples with high ASA levels. In unselected samples, ASA-positive samples (cut-off 50%) showed decreased sperm kinematics (VSL, VAP, LIN, ALH, STR, BCF, WOB), but in normozoospermic samples, ASA-positive and ASA-negative subgroups had similar CASA results. CONCLUSIONS ASA evaluation is highly relevant in full semen assessment.
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Affiliation(s)
- Gustavo Luis Verón
- Instituto de Biología y Medicina Experimental (IBYME; CONICET-FIBYME), Ciudad Autónoma de Buenos Aires, Argentina
| | | | | | | | - Clara Isabel Marín-Briggiler
- Instituto de Biología y Medicina Experimental (IBYME; CONICET-FIBYME), Ciudad Autónoma de Buenos Aires, Argentina
| | - Mónica Hebe Vazquez-Levin
- Instituto de Biología y Medicina Experimental (IBYME; CONICET-FIBYME), Ciudad Autónoma de Buenos Aires, Argentina
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Yasin AL, Yasin AL, Basha WS. The Epidemiology of Anti-Sperm Antibodies Among Couples with Unexplained Infertility in North West Bank, Palestine. J Clin Diagn Res 2016; 10:QC01-3. [PMID: 27134944 PMCID: PMC4843329 DOI: 10.7860/jcdr/2016/15788.7380] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2015] [Accepted: 10/11/2015] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Anti sperm antibodies (ASA) can present in serum and semen and they may lead to impair the sperms function leading to infertility. The precise mechanism of generation of these antibodies is yet to be discovered. AIM This study was performed to determine the prevalence of anti-sperm antibodies (ASA) in patients with unexplained infertility. The study was initiated also to explore the possible factors that may associate with ASA formation and how ASA status is associated with pregnancy rates after going with in vitro fertilization - intracytoplasmic sperm injection (IVF-ICSI). MATERIALS AND METHODS A cross-sectional study was conducted on 42 normal infertile couples consulting Razan Medical Center for Infertility & I.V.F. in Nablus, Palestine, from December 2012 - March 2013. Serum levels of immunoglobulins G (IgG) ASA were measured in participants (males and females) using enzyme-linked immunosorbent assay (ELISA). In addition, participants also filled a questionnaire about the presence of previous varicocele repair, inguinal hernia repair, orchitis, testicular trauma and vasectomy reversal among males and severe coitus bleeding and coitus during menses or puerperium among females. Couples were also asked about previous IVF-ICSI procedures and the outcome of the procedure in terms of either they got pregnant or not. Data was analysed using SPSS software. RESULTS The prevalence of ASA was 14.3% (6/42) among all couples, 9.5% (4/42) among males and 4.8% (2/42) among females. There was no significant relationship between previous varicocele repair, previous inguinal hernia repair, or orchitis and formation of ASA (p value =0.64, 0.56, and 0.26 respectively). Previous trauma, vasovasostomy, severe coitus bleeding and coitus during menses or puerperium were not observed in any of the study sample. ASA did not seem to affect the outcome of IVF-ICSI (p-value =0.54). CONCLUSION Prevalence of ASA in infertile couples in the north part of Palestine is similar to that obtained worldwide. ASA formation does not relate to any of the studied risk factors and does not seem to associate with pregnancy rate after IVF-ICSI. We recommend further studies using a larger sample size and including all parts of Palestine in order to generalize the obtained results.
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Affiliation(s)
- Anas Lotfi Yasin
- Research and Teaching Assistant, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
| | | | - Walid Salim Basha
- Professor and Head, Department of Biomedical Sciences-Faculty of Medicne and Health Sciences, An-Najah National University, Nablus, Palestine
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Talebi Farahani M, Hoseini F, Minai-Tehrani A, Ghafari Novin M. The Effect of Infection With Genital Mycoplasma hominis and the Presence of Antisperm Antibodies in Iranian Women With Unexplained Infertility. INTERNATIONAL JOURNAL OF WOMENS HEALTH AND REPRODUCTION SCIENCES 2016. [DOI: 10.15296/ijwhr.2016.05] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Stevenson EL, Hershberger PE, Bergh PA. Evidence-Based Care for Couples With Infertility. J Obstet Gynecol Neonatal Nurs 2015; 45:100-10; quiz e1-2. [PMID: 26815804 DOI: 10.1016/j.jogn.2015.10.006] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/01/2015] [Indexed: 11/29/2022] Open
Abstract
When couples cannot achieve pregnancy, they often seek health care from medical and nursing specialists. The care the couple receives begins with a thorough assessment to determine the possible cause of infertility and to plan appropriate care to ensure the best chance for the couple to have a biological child. In this article, we provide an overview of the etiology and evaluation of infertility, the various treatment options available, and the appropriate clinical implications.
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Tahmasbpour E, Balasubramanian D, Agarwal A. A multi-faceted approach to understanding male infertility: gene mutations, molecular defects and assisted reproductive techniques (ART). J Assist Reprod Genet 2014; 31:1115-37. [PMID: 25117645 PMCID: PMC4156950 DOI: 10.1007/s10815-014-0280-6] [Citation(s) in RCA: 73] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2014] [Accepted: 06/16/2014] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND The assisted reproductive techniques aimed to assist infertile couples have their own offspring carry significant risks of passing on molecular defects to next generations. RESULTS Novel breakthroughs in gene and protein interactions have been achieved in the field of male infertility using genome-wide proteomics and transcriptomics technologies. CONCLUSION Male Infertility is a complex and multifactorial disorder. SIGNIFICANCE This review provides a comprehensive, up-to-date evaluation of the multifactorial factors involved in male infertility. These factors need to be first assessed and understood before we can successfully treat male infertility.
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Affiliation(s)
| | | | - Ashok Agarwal
- />Center for Reproductive Medicine, Cleveland Clinic, 44195 Cleveland, OH USA
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10
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Vazquez-Levin MH, Marín-Briggiler CI, Veaute C. Antisperm antibodies: invaluable tools toward the identification of sperm proteins involved in fertilization. Am J Reprod Immunol 2014; 72:206-18. [PMID: 24863647 DOI: 10.1111/aji.12272] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2014] [Accepted: 04/28/2014] [Indexed: 12/18/2022] Open
Abstract
The identification of sperm proteins involved in fertilization has been the subject of numerous investigations. Much interest has been dedicated to naturally occurring antisperm antibodies (ASA) and their impact in fertility. Their presence in men and women has been associated with 2-50% of infertility cases. ASA may impair pre- and post-fertilization steps. Experimental models have been developed using sperm proteins as immunogens to evaluate their involvement in sperm function. Our team has pursued investigations to assess ASA presence in biological fluids from patients consulting for infertility and their effect on fertilization. We found ASA in follicular fluids with ability of inducing the acrosome reaction and blocking sperm-zona pellucida interaction and used them to identify sperm entities involved in these events. We generated and utilized antibodies against proacrosin/acrosin to characterize the sperm protease system. We implemented an ELISA to detect proacrosin/acrosin antibodies in human sera and evaluated their impact upon fertility by developing in vitro assays and a gene immunization model. This review presents a summary of ASA history, etiology, current approaches for detection and effects upon fertility. ASA (naturally occurring, generated by animal immunization and/or of commercial origin) are invaluable tools to understand the molecular basis of fertilization, better diagnose/treat immunoinfertility and develop immunocontraceptive methods.
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Affiliation(s)
- Mónica H Vazquez-Levin
- Instituto de Biología y Medicina Experimental (IBYME), National Research Council of Argentina (CONICET), Buenos Aires, Argentina
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Carlsson L, Ronquist G, Nilsson BO, Larsson A. Dominant Prostasome Immunogens for Sperm-Agglutinating Autoantibodies of Infertile Men. ACTA ACUST UNITED AC 2013; 25:699-705. [PMID: 15292099 DOI: 10.1002/j.1939-4640.2004.tb02844.x] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The presence of naturally occurring anti-sperm antibodies (ASA) is a well-known cause of infertility in men and women, but the antigens for these antibodies are poorly characterized. We have previously shown that prostasomes adhere to sperm cells and that prostasomes are major targets for ASA associated with infertility. These autoantigens have not been characterized. We used 2-dimensional electrophoresis, immunoblotting, and mass-spectrometry to identify the prostasome antigens for these autoantibodies. By these techniques, we revealed that prolactin-inducible protein (PIP) and clusterin were dominant prostasome immunogens for sperm-agglutinating autoantibodies of 20 patients with immunological infertility. PIP was identified by 19 of 20 (95%) patient sera and clusterin by 17 of 20 (85%). In addition, 10 sporadically occurring prostasomal antigens were identified in this context, viz alcohol dehydrogenase [NADP+], annexin I, annexin III, BRCA1-associated ring domain protein 1, heat shock 27-kd protein, isocitrate dehydrogenase, lactoylglutathione lyase, NG,NG-dimethylarginine dimethylaminohydrolase 1, peroxiredoxin 2, and syntenin 1.
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Affiliation(s)
- Lena Carlsson
- Department of Medical Sciences, University Hospital, S-751 85 Uppsala, Sweden
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Brunner-Agten S, Pavlovic R, Müller L, Horn M, Huber A, Stadler B, Vogel M. Increased Level of Antibodies Cross-Reacting with Ves v 5 and CRISP-2 in MAR-Positive Patients. Int Arch Allergy Immunol 2013; 160:47-55. [DOI: 10.1159/000338946] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2011] [Accepted: 04/18/2012] [Indexed: 01/03/2023] Open
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Fu J, Wang Y, Fok KL, Yang D, Qiu Y, Chan HC, Koide SS, Miao S, Wang L. Anti-ACTL7a antibodies: a cause of infertility. Fertil Steril 2012; 97:1226-33.e1-8. [DOI: 10.1016/j.fertnstert.2012.02.023] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2011] [Revised: 01/31/2012] [Accepted: 02/16/2012] [Indexed: 10/28/2022]
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Carp HJ, Selmi C, Shoenfeld Y. The autoimmune bases of infertility and pregnancy loss. J Autoimmun 2012; 38:J266-74. [PMID: 22284905 DOI: 10.1016/j.jaut.2011.11.016] [Citation(s) in RCA: 151] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2011] [Revised: 11/28/2011] [Accepted: 11/28/2011] [Indexed: 11/26/2022]
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Ronquist G. Prostasomes are mediators of intercellular communication: from basic research to clinical implications. J Intern Med 2012; 271:400-13. [PMID: 22112042 DOI: 10.1111/j.1365-2796.2011.02487.x] [Citation(s) in RCA: 100] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Prostasomes are nanosized microvesicles secreted by acinar epithelial cells of the prostate gland. Furthermore, they are intracellular microvesicles inside another larger vesicle, a so-called storage vesicle, equivalent to multivesicular bodies of late endosomal origin. Prostasomes are thought to play an important role in intercellular communication by direct interaction primarily between the immobile acinar cells of the prostate gland and the mobile spermatozoa. Prostasomes transfer not only membrane components but also genetic material to spermatozoa. They are rich in various transferable bioactive molecules (e.g., receptors and enzymes) that promote the fertilizing ability of spermatozoa. In this review, the pleiotropic biological effects of prostasomes that are relevant for successful fertilization will be discussed. The ability to synthesize and export prostasomes to the extracellular space is observed not only in normal prostate epithelial cells but also in malignant prostate cells. Release of prostasomes by prostate cancer cells suggests a role in malignant cell growth and proliferation. These findings may provide new therapeutic and diagnostic strategies.
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Affiliation(s)
- G Ronquist
- Department of Medical Sciences, Clinical Chemistry, University Hospital, Uppsala, Sweden.
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16
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Abstract
The evaluation of the infertile male continues to be a clinical challenge of increasing significance with considerable emotional and financial burdens. Many physiological, environmental and genetic factors are implicated; however, the etiology of suboptimal semen quality is poorly understood. This review focuses on the diagnostic testing currently available, as well as future directions that will be helpful for the practicing urologist and other clinicians to fully evaluate the infertile male.
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Hwang K, Walters RC, Lipshultz LI. Contemporary concepts in the evaluation and management of male infertility. Nat Rev Urol 2011; 8:86-94. [PMID: 21243017 PMCID: PMC3654691 DOI: 10.1038/nrurol.2010.230] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Infertility in men is a common condition. At the core of the medical evaluation of the male partner in a couple who are unable to conceive is the history and physical examination. Special attention should be directed to the patient's developmental history and any use of testosterone products. The physical examination focuses on the genitals, and includes assessments of the size and consistency of the testicles, epididymis, vas deferens, and presence of varicoceles. Although many sophisticated tests are available, semen analysis is still the most important diagnostic tool used to assess fertility, and includes parameters such as sperm count, motility and viability. Treatment of male factor infertility can involve targeted agents, in the case of specific conditions such as hypogonadotropic hypogonadism, or it can be empirical-using medical therapy or assisted conception techniques-for patients in whom no underlying cause has been identified. Although an all-encompassing treatment for male factor infertility has not yet been developed, the field offers many promising avenues of research.
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Affiliation(s)
- Kathleen Hwang
- Scott Department of Urology, Baylor College of Medicine, 6624 Fannin Street, Suite 1700, Houston, TX 77030, USA
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18
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Anti-sperm antibody levels are not related to fertilization or pregnancy rates after IVF or IVF/ICSI. J Reprod Immunol 2011; 88:80-4. [DOI: 10.1016/j.jri.2010.09.002] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2010] [Revised: 08/12/2010] [Accepted: 09/22/2010] [Indexed: 11/19/2022]
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Dun MD, Mitchell LA, Aitken RJ, Nixon B. Sperm-zona pellucida interaction: molecular mechanisms and the potential for contraceptive intervention. Handb Exp Pharmacol 2010:139-178. [PMID: 20839091 DOI: 10.1007/978-3-642-02062-9_9] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
At the moment of insemination, millions of mammalian sperm cells are released into the female reproductive tract with the single goal of finding the oocyte. The spermatozoa subsequently ignore the thousands of cells they make contact with during their journey to the site of fertilization, until they reach the surface of the oocyte. At this point, they bind tenaciously to the acellular coat, known as the zona pellucida, which surrounds the oocyte and orchestrate a cascade of cellular interactions that culminate in fertilization. These exquisitely cell- and species- specific recognition events are among the most strategically important cellular interactions in biology. Understanding the cellular and molecular mechanisms that underpin them has implications for the etiology of human infertility and the development of novel targets for fertility regulation. Herein we describe our current understanding of the molecular basis of successful sperm-zona pellucida binding.
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Affiliation(s)
- Matthew D Dun
- Reproductive Science Group, School of Environmental & Life Sciences, University of Newcastle, Callaghan, NSW, 2308, Australia
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Lee R, Goldstein M, Ullery BW, Ehrlich J, Soares M, Razzano RA, Herman MP, Callahan MA, Li PS, Schlegel PN, Witkin SS. Value of serum antisperm antibodies in diagnosing obstructive azoospermia. J Urol 2008; 181:264-9. [PMID: 19013620 DOI: 10.1016/j.juro.2008.09.004] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2008] [Indexed: 10/21/2022]
Abstract
PURPOSE The requisite presence of active spermatogenesis for antisperm antibody production may be useful in identifying obstructive azoospermia. The diagnostic performance of serum antisperm antibody was evaluated as a test for obstructive azoospermia. MATERIALS AND METHODS A total of 484 men with male infertility who had undergone antisperm antibody testing were evaluated. Demographic data, patient history, and followup were recorded. Obstruction was confirmed by surgical exploration. Sensitivity, specificity, positive and negative predictive values, and positive and negative likelihood ratios were calculated to quantify diagnostic performance. ROC curves were calculated and compared. RESULTS Of 484 men 272 possessed documented obstruction of the vas or epididymis and 212 had documented infertility without azoospermia. The obstructed group had significantly increased antisperm antibody levels compared to the nonobstructed group. IgG, IgA, and IgM were analyzed as diagnostic tests for obstruction. The AUC for IgG, IgA and IgM ROC curves was 0.92, 0.85 and 0.67, respectively. The AUC for serum IgG against sperm tails was 0.92, 0.87 against sperm heads and 0.79 against sperm midpieces. IgG demonstrated the highest sensitivity (85%) with a specificity of 97% (chi-square test p <0.01). IgA possessed the highest specificity (99%), positive predictive value (99%) and positive likelihood ratio (70.0). CONCLUSIONS The presence of serum antisperm antibody was highly accurate in predicting obstructive azoospermia, particularly after vasectomy. It can obviate the need for testis biopsy, the current but more invasive and costly gold standard of detection. This allows the surgeon to proceed directly to surgical reconstruction or sperm retrieval after a simple blood test.
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Affiliation(s)
- Richard Lee
- The Center for Male Reproductive Medicine and Microsurgery, Department of Urology and Cornell Institute for Reproductive Medicine, New York, New York, USA
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Wang Y, Zhang N, Zhang X, Miao S, Zong S, Koide SS, Wang L. Experimental immunological infertility effect of anti-GAPDH-2 antibodies on the fertility of female mice. Fertil Steril 2008; 92:2020-7. [PMID: 18980760 DOI: 10.1016/j.fertnstert.2008.09.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2008] [Revised: 08/23/2008] [Accepted: 09/02/2008] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To examine the relationship between an antibody against GAPDH-2, a sperm-specific protein, and infertility of female mice. DESIGN Basic research. SETTING National Research Institute for Family Planning Beijing, World Health Organization Collaboration Center of Human Reproduction. ANIMAL(S) New Zealand rabbit, NIH and ICR mice. INTERVENTION(S) None. MAIN OUTCOME MEASURE(S) Enzyme-linked immunoabsorbent assay, Western blot and indirect immunostaining assays, standard fertility assay, and sperm agglutination assay. RESULT(S) Antibodies against the full-length GAPDH-2 were raised. Its specificity was assessed by immunoblotting and indirect immunostaining assays. The antibody immunoreacted with human sperm GAPDH-2 and the mouse homolog GAPDS but did not cross-react with GAPDH. Treatment of female mice with IP injection of anti-GAPDH-2 serum significantly reduced their fertility. Anti-GAPDH-2 serum caused the agglutination of normal mice sperm in vitro. The anti-GAPDH-2 antibody was detectable in the sera and uterine fluid of the mice immunized with GAPDH-2. CONCLUSION(S) These results show that GAPDH-2 should be further evaluated as a promising candidate in the development of an antifertility immunogen. Detecting anti-GAPDH-2 antibodies in the bodily fluid of subjects afflicted with indeterminate infertility may be a new diagnostic index.
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Affiliation(s)
- Yong Wang
- National Laboratory of Medical Molecular Biology, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences, Peking Union Medical College, Tsinghua University, Beijing, People's Republic of China
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Ahangari G, Naderimanesh H, Hossein-Nezhad A, Zouali M. A novel tissue engineering-based assay for immunological infertility. Scand J Immunol 2008; 68:463-8. [PMID: 18782277 DOI: 10.1111/j.1365-3083.2008.02160.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Antisperm antibodies (ASA) are present in 9-36% of infertile couples, a condition called immunological infertility. The variability of ASA in terms of antigenic specificity and biological effects has made it difficult to design a test able to distinguish reliably between ASA that contribute to infertility and those that do not. To develop a reliable and reproducible method able to detect sperm antibodies, we took advantage of recent progress made in tissue engineering techniques. We used collagen gel as a bio-scaffold for the production of engineered sperm analogues. The advantages of using collagen gels include biocompatibility, ease of fabrication and low cost. We found that this tissue engineering-based assay is more specific and more sensitive than a conventional test routinely used for ASA detection. In addition, it exhibited low intra- and inter-variations. We envision the use of this novel approach for the detection of a variety of autoantibodies in autoimmune diseases. In addition to diagnostic purposes, tissue-engineering based tests could be useful in monitoring treatments with bio-drugs.
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Affiliation(s)
- G Ahangari
- Department of Molecular Medicine and Immunology, National Institute for Genetic Engineering and Biotechnology, Tehran, Iran.
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23
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Williams J, Samuel A, Naz RK. ORIGINAL ARTICLE: Presence of Antisperm Antibodies Reactive with Peptide Epitopes of FA-1 and YLP12 in Sera of Immunoinfertile Women. Am J Reprod Immunol 2008; 59:518-24. [DOI: 10.1111/j.1600-0897.2008.00581.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Abstract
Sperm have been known to be antigenic for more than a century. There is a strong body of evidence that in humans and in other species at least some antibodies that bind to sperm antigens can cause infertility. Therefore, these antibodies are of interest today for two practical reasons. Firstly, the association of the antibodies with infertility means that they must be detected and then the couples treated appropriately. Secondly, because these antibodies can induce infertility they have the potential to be developed for contraceptive purposes in humans and also for the control of feral animal populations.
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Affiliation(s)
- L W Chamley
- Department of Obstetrics and Gynaecology, University of Auckland, Auckland, New Zealand.
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25
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26
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Garcia PC, Rubio EM, Pereira OCM. Antisperm antibodies in infertile men and their correlation with seminal parameters. Reprod Med Biol 2007; 6:33-38. [PMID: 29699263 PMCID: PMC5906834 DOI: 10.1111/j.1447-0578.2007.00162.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Aim: Antisperm antibodies (ASA) in males cause the autoimmune disease 'immune infertility'. The present study intended to detect the presence of ASA and their incidence in men with unexplained infertility, as well as to evaluate the correlation between the presence of ASA and semen parameter alterations. Methods: Blood and sperm assessment were collected to carry out a direct and indirect mixed antiglobulin reaction (MAR) test and semen analysis in infertile and fertile men from the University Hospital of the Faculty of Medicine, Sao Paulo State University, Sao Paulo. Results: In the MAR test, 18.18% of infertile men were positive for ASA. In fertile men, no positivity was found. A significant correlation between the presence of ASA with an increased white blood cell count plus a decreased hypoosmotic swelling test result was observed. Conclusions: The results indicate that ASA are involved in reduced fertility. It is not ASA detection per se that provides conclusive information about the occurrence of damage to fertility. The correlation between infertility and altered seminal parameters reinforce the ASA participation in this pathology. (Reprod Med Biol 2007; 6: 33-38).
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Affiliation(s)
| | - Eliana M Rubio
- Department of Urology, Faculty of Medicine, Sao Paulo State University (UNESP), Botucatu, Sao Paulo, Brazil
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Bhande S, Naz RK. Molecular identities of human sperm proteins reactive with antibodies in sera of immunoinfertile women. Mol Reprod Dev 2006; 74:332-40. [PMID: 16998854 DOI: 10.1002/mrd.20643] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Antisperm antibodies (ASA) can cause infertility in both men and women. It is important to delineate the sperm antigens against which these ASA are directed. Sperm proteins were separated by 2D gel electrophoresis and transferred to nitrocellulose membrane and incubated with sera from fertile women or immunoinfertile women having ASA. The corresponding immunoreactive peptide spots were cored from the gel and analyzed by the two-dimensional (2D) gel electrophoresis/matrix-assisted laser desoprtion ionization-time of flight-mass spectrometry and liquid chromatography-mass spectrometry (MALDI-TOF-MS/LC-MS). A total of 68 spots belonging to 38 different proteins and their isomers were identified. Fourteen of these proteins and their isomers reacted with both the fertile and immunoinfertile sera. Twenty-four of these proteins reacted specifically only with the immunoinfertile sera and not with the fertile sera. Among them was a novel protein designated as a hypothetical protein FLJ32704 (accession # Q96MA6). An immunodominant sequence (amino acid 151-159) of this protein was identified and a nonamer peptide based upon this sequence (IQTLG1TPR) was synthesized and examined for its immunoreactivity. This synthetic peptide reacted with 90% (36/40) of immunoinfertile sera and not with any of the fertile sera (0/40) in the enzyme-linked immnosorbent assay (ELISA). In conclusion, using the 2D gel electrophoresis/MALDI-TOF-MS/LC-MS procedure, we have identified several known and at least one novel antigen against which the antibodies are present in sera of immunoinfertile but not fertile women. Some of these antigens may find applications in specific diagonsis and treatment of infertility/immunoinfertility, and in the development of new generation of contraceptive modalities including contraceptive vaccines.
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Affiliation(s)
- Satish Bhande
- Department of Obstetrics and Gynecology, Reproductive Immunology and Molecular Biology Laboratories, School of Medicine, The West Virginia University, Morgantown, West Virginia 26505-9186, USA
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28
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Abstract
Antisperm antibodies (ASA) are present in a high percentage of infertile patients. The development of ASA in the male depends on the sequestration of antigens on germ cells, the testis being an immune privileged region. In this study, we investigated the specificity of ASA binding to sperm antigens by exposing a number of organ preparations to ASA. In none of the organ homogenates was a significant difference between the results of the Western blot with ASA-containing fluids, neither serum nor seminal plasma, and those without ASA observed. We conclude from our results that the ASA tested in our study obviously are sperm-specific. ASA as an autoimmune are thus restricted to spermatozoa. The antigens are suitable for trials in immune therapy, they may also serve for the development of antigen-specific diagnosis and treatment in infertility. They also indicate cognate antigens of possible immune contraceptive agents.
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Affiliation(s)
- H Dörr
- Department of Andrology and Venerology, University Hospital, Philipp University, Deutschhausstrasse 9, D-35033 Marburg, Germany
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29
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Shibahara H, Shiraishi Y, Suzuki M. Diagnosis and treatment of immunologically infertile males with antisperm antibodies. Reprod Med Biol 2005; 4:133-141. [PMID: 29699216 DOI: 10.1111/j.1447-0578.2005.00102.x] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
The presence of antisperm antibodies (ASA) can reduce fecundity in both males and females. The present review describes a strategy, established by investigations of the diverse inhibitory effects of ASA on fertility, for the appropriate diagnosis and treatment of infertile males with ASA. For infertile males with ASA, diagnosis using the direct-immunobead test (D-IBT), the postcoital test (PCT) and the hemizona assay (HZA) should be carried out as the basis for decision-making. If the patient with ASA has an abnormal hemizona index, it seems reasonable to advise selecting intracytoplasmic sperm injection-embryo transfer (ICSI-ET) as a primary treatment. However, it has been shown that some immunologically infertile males with normal fertilizing ability established pregnancy by timed intercourse (TI) or intrauterine insemination (IUI). In such patients with ASA having normal hemizona index, TI or IUI can be selected based on the PCT result. Therefore, the treatment strategy for males with ASA is similar to that for infertile males with oligozoospermia or asthenozoospermia. In conclusion, it should be emphasized that a diversity of ASA exists and their effects on fertility in infertile males. Although there is an argument that routine testing for ASA in males is not always necessary, one should be aware that in some cases of failed IUI or IVF, ICSI is selected afterward because of the diagnosis of ASA. (Reprod Med Biol 2005; 4: 133-141).
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Affiliation(s)
- Hiroaki Shibahara
- Department of Obstetrics and Gynecology, Jichi Medical School, Tochigi, Japan
| | - Yasuko Shiraishi
- Department of Obstetrics and Gynecology, Jichi Medical School, Tochigi, Japan
| | - Mitsuaki Suzuki
- Department of Obstetrics and Gynecology, Jichi Medical School, Tochigi, Japan
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30
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Naz RK. Search for peptide sequences involved in human antisperm antibody-mediated male immunoinfertility by using phage display technology. Mol Reprod Dev 2005; 72:25-30. [PMID: 15895468 DOI: 10.1002/mrd.20315] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
The aim of the present study was to delineate peptide sequences against which antisperm antibodies (ASA) are raised in immunoinfertile men. Using the phage display technology, seven unique and novel dodecamer amino acid sequences were identified that reacted with the sera of immunoinfertile men. The peptides were synthesized based upon these amino acid sequences and examined for their immunoreactivity with sera from ASA-positive immunofertile men (n = 15) and ASA-negative fertile men (n = 18) for IgM, IgG, and IgA class of antibody in the enzyme-linked immunosorbent assay (ELISA). All the seven synthetic peptides showed a significantly (P < 0.001) higher mean absorbance values for IgG and/or IgA class of antibody with the immunoinfertile sera compared to fertile control sera. Three of the seven peptides demonstrated a stronger reaction (>2 SD units) with 27%-40% of immunoinfertile sera compared to fertile controls. These peptide sequences may find applications in the specific diagnosis and treatment of immunoinfertility and in contraceptive vaccine development. The phage display technique provides an exciting and novel technology to delineate sperm epitopes involved in immunoinfertility.
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Affiliation(s)
- Rajesh K Naz
- Division of Research, Department of Obstetrics and Gynecology, Health Education Building, Medical College of Ohio, Toledo, Ohio, USA.
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31
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Carlsson L, Larsson A, Ronquist G, Nilsson BO. Prostasome antigens as targets for sperm agglutinating antibodies demonstrated by 1-D gel electrophoresis and immunoblottings. ACTA ACUST UNITED AC 2004; 27:360-7. [PMID: 15595955 DOI: 10.1111/j.1365-2605.2004.00468.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Many immunoinfertile men have sperm agglutinating antibodies that are directed against prostasome-derived antigens, but these antigens have not been defined so far. We selected serum samples with high ELISA titres against prostasomes from a group of immunoinfertile patients with sperm agglutinating antibodies and used the sera for immunoblottings on 1-D SDS-PAGE of prostasomes and sperm cells. The immunoblottings with individual antiprostasome antisera on 1-D SDS-PAGE of prostasomes, revealed three to 10 bands for each serum. Eighty-five per cent of the serum samples contained bands in the 70-75 kDa region and 80% of the samples contained bands in the 50-55 kDa region. Immunoblottings of extracted sperm cells, revealed one to six bands in the molecular weight range 25-82 kDa and two of the samples recognized two bands with molecular weights (50 and 43 kDa) similar to immunoblottings of prostasomes. The prostasomal antigens recognized by the high titre-antisera of immunoinfertile men were generally different from the sperm antigens recognized by the same sera. This suggests that prostasomes offer a new set of antigens available for research on male immunoinfertility and immunocontraception.
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Affiliation(s)
- L Carlsson
- Department of Medical Cell Biology, Biomedical Center, University of Uppsala, S-751 85 Uppsala, Sweden
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Chiu WWC, Chamley LW. Clinical associations and mechanisms of action of antisperm antibodies. Fertil Steril 2004; 82:529-35. [PMID: 15374685 DOI: 10.1016/j.fertnstert.2003.09.084] [Citation(s) in RCA: 71] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2003] [Revised: 09/29/2003] [Accepted: 09/29/2003] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To review and critique the current English literature describing the effects of antisperm antibodies (ASA) on mammalian fertility. DESIGN A comprehensive English language literature was searched using Medline and by hand-searching. Emphasis was placed on clinically relevant articles. RESULT(S) Results from the studies were extrapolated and the effects of ASA on fertility described. CONCLUSION(S) Antisperm antibodies may interfere with fertility. Not all ASA cause infertility. Current tests cannot differentiate the infertility-related ASA from those that do not interfere with infertility, because the antigenic specificities of these ASA are not known. The antigens which the infertility-related ASA must be characterized to allow an accurate detection and proper treatment for couples with ASA.
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Affiliation(s)
- Will W-C Chiu
- Department of Obstetrics and Gynecology, University of Auckland, Auckland 3, New Zealand
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34
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Abstract
Immunoinfertility because of antisperm antibodies (ASA) is an important cause of infertility in humans. The incidence of ASA in infertile couples is 9-36% depending on the reporting center. Early claims regarding the incidence and involvement of ASA in involuntary infertility were probably overemphasized, which has resulted in subsequent confusion, doubt, and underestimation of their clinical significance. No immunoglobulin that binds to sperm should be called an antisperm antibody in a strict sense unless it is directed against a sperm antigen that plays a role in fertilization and fertility. ASA directed against the fertilization-related antigens are more relevant to infertility than the immunoglobulins that bind to sperm associated antigens. Several methods have been reported for treatment of immunoinfertility. These include: immunosuppressive therapies using corticosteroids or cyclosporine; assisted reproductive technologies such as intrauterine insemination, gamete intrafallopian transfer, in vitro fertilization, and intracytoplasmic sperm injection; laboratory techniques such as sperm washing, immunomagnetic sperm separation, proteolytic enzyme treatment, and use of immunobeads. Most of the available techniques have side effects, are invasive and expensive, have low efficacy, or provide conflicting results. Recent findings using defined sperm antigens that have a role in fertilization/fertility have provided animal models and innovative novel perspectives for studying the mechanism of immunoinfertility and possible modalities for treatment. The better understanding of local immunity and latest advances in hybridoma and recombinant technologies, proteomics and genomics leading to characterization of sperm antigens relevant to fertility will help to clarify the controversy and to establish the significance of ASA in infertility.
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Affiliation(s)
- Rajesh K Naz
- Division of Research, Department of Obstetrics and Gynecology, Medical College of Ohio, OH 43614-5806, USA.
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Bohring C, Krause W. Characterization of spermatozoa surface antigens by antisperm antibodies and its influence on acrosomal exocytosis. Am J Reprod Immunol 2004; 50:411-9. [PMID: 14750700 DOI: 10.1034/j.1600-0897.2003.00103.x] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
PROBLEM Antisperm antibodies (ASA) are the main cause of immunological infertility, they impair sperm functions by binding to the sperm membrane. The aim of this study was to characterize highly enriched sperm membrane proteins by 2-D-electrophoresis and to identify membrane antigens binding ASA and to evaluate the influence of ASA on the acrosome reaction (AR). METHOD OF STUDY Sperm membrane proteins were separated by 2-D-electrophoresis and antigens were identified by immunoblotting with ASA from seminal plasma samples of infertile men. The influence of ASA on the AR were observed and determined by means of flowcytometry. RESULTS A total of 18 antigens were identified by using ASA from seminal plasma. Six of the recognized proteins were analyzed by means of mass spectrometry and peptide matching: HSP70 and HSP70-2, disulfide-isomerase-ER60, caspase-3 and two subunits of the proteasome (component-C2 and zeta-chain). ASA from seminal plasma are able to enhance the AR in donor-spermatozoa. CONCLUSION The biochemical identification of these proteins will be helpful to understand the mechanism by which ASA impair sperm function and the fertilization process. Spermatozoa, in which the AR was prematurely induced by ASA, will not be able to fertilize anymore.
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Affiliation(s)
- Claudia Bohring
- Department of Andrology, Clinical Training Center of the European Academy of Andrology, University Hospital Marburg, Germany.
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36
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Abstract
There is a male factor involved in up to half of all infertile couples. Potential etiologies in male factor infertility are many and require thorough evaluation for their accurate identification. A complete medical history in conjunction with a focused examination can allow for an appropriate choice of laboratory and imaging studies. The semen analysis is a crucial first step, but by no means is it sufficient to determine a specific etiology or dictate therapy. A systematic approach is necessary to help guide the work-up and rule out less likely causes. The etiologies discussed within this article are tremendously broad, and the prognosis for any given couple depends, in large part, on the etiology. Without a firm understanding of the genetics, anatomy, physiology, and complex interplay of the male reproductive system, the evaluation becomes an inefficient exercise that often fails to define the precise etiology. Couples with male factor infertility need a systematic approach with the efficiency of ultimate treatment determined largely by the physician's ability to identify the specific cause of the man's reproductive failure.
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Affiliation(s)
- Victor M Brugh
- Department of Urology, Eastern Virginia Medical School, 400 West Brambleton Avenue, Suite 100, Norfolk, VA 23510, USA
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37
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Barthélémy C. Indications de la recherche des anticorps anti-spermatozoïdes. ACTA ACUST UNITED AC 2003. [DOI: 10.1007/bf03034413] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Bohring C, Krause W. Interlaboratory variability of the indirect mixed antiglobulin reaction in the assessment of antisperm antibodies. Fertil Steril 2002; 78:1336-8. [PMID: 12477539 DOI: 10.1016/s0015-0282(02)04282-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Shibahara H, Tsunoda T, Taneichi A, Hirano Y, Ohno A, Takamizawa S, Yamaguchi C, Tsunoda H, Sato I. Diversity of antisperm antibodies bound to sperm surface in male immunological infertility. Am J Reprod Immunol 2002; 47:146-50. [PMID: 12069199 DOI: 10.1034/j.1600-0897.2002.1o059.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
PROBLEM The presence of antisperm antibodies (ASA) in males can reduce fecundity, however, relationship between the two is disputed. This study was performed to investigate if there is diversity of ASA bound to sperm surface using immunobead test (IBT) combined with complement dependent sperm immobilization test (SIT). METHODS The ASA bound to sperm surface were detected using the direct IBT (D-IBT) in 275 semen samples. In some cases with ASA detected by D-IBT, sperm immobilizing antibodies bound to sperm surface were also evaluated using direct SIT (D-SIT). RESULTS The incidence of the immunoglobulin G (IgG), IgA, and IgM classes of ASA detected by D-IBT were 2.5, 1.8, and 0.4%, respectively. Totally, nine (3.3%) infertile men had ASA on the sperm surface. D-SIT was tested positive in four (66.7%) of six cases with ASA assessed by D-IBT. CONCLUSIONS Some of the sperm-bound antibodies are associated with complement dependent sperm immobilizing antibodies, indicating that there exists a heterogeneity of sperm-bound antibodies. This result might be one of the reasons for the controversy about the relationship between ASA and immunological infertility in men.
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Affiliation(s)
- Hiroaki Shibahara
- Department of Obstetrics and Gynecology, Jichi Medical School, Tochigi, Japan.
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DIFFERENCES IN THE ANTIGEN PATTERN RECOGNIZED BY ANTISPERM ANTIBODIES IN PATIENTS WITH INFERTILITY AND VASECTOMY. J Urol 2001. [DOI: 10.1016/s0022-5347(05)65941-1] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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42
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DIFFERENCES IN THE ANTIGEN PATTERN RECOGNIZED BY ANTISPERM ANTIBODIES IN PATIENTS WITH INFERTILITY AND VASECTOMY. J Urol 2001. [DOI: 10.1097/00005392-200109000-00103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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43
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Nikolaeva MA, Kulakov VI, Korotkova IV, Golubeva EL, Kuyavskaya DV, Sukhikh GT. Antisperm antibodies detection by flow cytometry is affected by aggregation of antigen-antibody complexes on the surface of spermatozoa. Hum Reprod 2000; 15:2545-53. [PMID: 11098024 DOI: 10.1093/humrep/15.12.2545] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Flow cytometry (FCM) analysis of live antibody-coated spermatozoa subjected to immunofluorescence staining (FCM test) is considered an objective method for the quantitative detection of antisperm antibodies (ASA). But the cross-linking of cell surface antigen (Ag) with bivalent antibodies and/or antigen-antibody (Ag-Ab) complexes with second antibodies may induce the reorganization of surface components (patching and capping) and result in their shedding from the sperm surface. The present study estimates the relationship between aggregation of Ag-Ab complexes on the sperm surface and the results of indirect FCM test. Swim-up spermatozoa of normozoospermic men were incubated with ASA-positive sera from infertile patients and with second antibodies fluorescein isothiocyanate (FITC)-labelled goat anti-human IgG polyclonal antiserum under different conditions and then analysed by FCM and fluorescence microscopy. It was shown that low temperature, cytochalasin B, excess or lack of the primary and/or secondary antibodies and sperm fixation by paraformaldehyde may inhibit aggregation and shedding of Ag-Ab complexes and dramatically increase ASA quantity determined on the sperm surface. However, inhibition of aggregation on the live sperm surface was observed only in a minority of ASA-positive samples and was poorly reproducible using semen of different donors. A high probability of Ag-Ab complex shedding from the sperm surface during experimental manipulation limits the use of indirect FCM test for quantitative ASA determination.
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Affiliation(s)
- M A Nikolaeva
- Laboratory of Clinical Immunology, Russian Scientific Centre for Obstetrics, Gynecology and Perinatology, Moscow, Russia.
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Bohring C, Krause W. The intra- and inter-assay variation of the indirect mixed antiglobulin reaction test: is a quality control suitable? Hum Reprod 1999; 14:1802-5. [PMID: 10402393 DOI: 10.1093/humrep/14.7.1802] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
The test most commonly used to detect sperm antibodies is the mixed antiglobulin reaction (MAR), standardized by the World Health Organization. The indirect MAR test detects soluble sperm antibodies in seminal plasma by using healthy donor spermatozoa as antigen. In this study we systematically investigated the influence of donor spermatozoa and the source of sperm antibodies upon the results of the indirect MAR test, and calculated the intra- and inter-assay variations. Using one individual seminal plasma and the same donor semen, results of the indirect MAR test are highly reproducible (low intra-assay variation). Two dimensions of inter-assay variation must be considered: (i) serial ejaculates of an individual donor may be used at different times; (ii) different donors may be applied to identical antibody sources. Donor spermatozoa strongly influenced the results of the indirect MAR test. Using multivariate statistical tests, highly significant main effects between the different donors (P < 0.001) and specific reciprocal effects between donor spermatozoa and seminal plasma samples (P < 0.001) were observed. The high inter-assay variation of the indirect MAR test will lead to incorrect results. There is urgent need of a reliable and reproducible test for sperm antibody detection to improve quality control of the methods.
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Affiliation(s)
- C Bohring
- Clinic of Dermatology, Department of Andrology, Clinical Training Center of the European Academy of Andrology, Philipp University, Deutschhausstrabetae 9, D-35033 Marburg, Germany
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Yakirevich E, Naot Y. Characterization of a potent sperm-agglutinating monoclonal antibody and its cognate antigens. Fertil Steril 1999; 71:502-10. [PMID: 10065789 DOI: 10.1016/s0015-0282(98)00506-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVE To identify sperm antigens that are capable of eliciting infertility-related sperm-agglutinating antibodies. DESIGN In vitro laboratory experiments. SETTING University research laboratory. PATIENT(S) Fertile semen donors. INTERVENTION(S) None. MAIN OUTCOME MEASURE(S) Sperm agglutination, immunofluorescence localization, and flow cytometric analysis of surface expression of A36 antigens. Antigen analysis by Western immunoblotting. RESULT(S) Monoclonal antibody A36 induced intensive head-to-head, tail-to-tail, and head-to-tail agglutination of motile human spermatozoa. Antigens recognized by A36 were localized on the acrosomal cap and in the principal tail regions of motile, noncapacitated human sperm. Changes in subcellular levels and localization of the A36-recognized epitope occurred after capacitation and acrosomal loss. A36 reacted with a polymorphic series of proteins in Western blots of sperm extracts from humans and various other animal species, including mouse testis extracts. A common 53-kd antigen was recognized by the antibody in the different antigenic preparations. CONCLUSION(S) A mouse antibody to human sperm, monoclonal antibody A36, caused intensive agglutination of noncapacitated human spermatozoa and reacted with antigens on the acrosomal cap and in the principal tail regions. Of the multiple polypeptides that were reactive with the monoclonal antibody in sperm extracts from humans and other animal species, a common 53-kd antigen was recognized.
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Affiliation(s)
- E Yakirevich
- Department of Immunology, Bruce Rappaport Faculty of Medicine, Technion, Haifa, Israel
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Khamsi F, Lacanna I, Endman M, Wong J. Recent advances in assisted reproductive technologies. Endocrine 1998; 9:15-25. [PMID: 9798726 DOI: 10.1385/endo:9:1:15] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/1998] [Revised: 05/06/1998] [Accepted: 05/13/1998] [Indexed: 11/11/2022]
Abstract
Assisted reproductive technologies (ART) have received considerable attention, both clinically and empirically. Drs. Steptoe and Edwards removed one oocyte surgically from a woman with infertility related to tubal disease. They fertilized this oocyte in vitro and transferred the formed embryo to the woman's uterus and achieved pregnancy and delivery. The technique of in vitro fertilization (IVF) and embryo transfer (ET) quickly became widely utilized for other causes of infertility as well as for tubal disease. In the last 5 years there has been a number of new developments that are reviewed in this article. The most important and now widely practiced technology has been direct intracytoplasmic injection (ICSI) of the husband's sperm into the wife's oocyte. This was developed for treatment of infertility related to low sperm count. Subsequently it was shown that sperm can be aspirated from epididymis or found in testicular biopsy in obstructive azoospermia. Another promising development is in vitro maturation (IVM) of immature oocytes. This has the potential of avoiding ovarian hyperstimulation, which can be uncomfortable and occasionally dangerous. Some oocytes are unable to fertilize and/or develop into normal embryos. It may be possible that the problem is with the machinery of cytoplasm of the oocyte. Therefore cytoplasmic transfer from a normal oocyte to an abnormal oocyte may overcome the problem. Infertile couples may be faced with many psychological problems that become even more complex with various treatments. Whereas donation of oocytes or embryos can be technically quite simple, there are many psychological issues involved. As can be gathered from aforementioned discussions, the treatments developed for infertility appear to be somewhat illogical and in the style of "shot gun therapy." In the field of infertility, as in other areas of medicine, it is of paramount importance to know the details of disease mechanisms. This in turn will allow specific and logical treatments to be developed.
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Affiliation(s)
- F Khamsi
- Toronto Fertility Sterility Institute, Department of Medicine, University of Toronto, Ontario, Canada.
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Abshagen K, Behre HM, Cooper TG, Nieschlag E. Influence of sperm surface antibodies on spontaneous pregnancy rates. Fertil Steril 1998; 70:355-6. [PMID: 9696234 DOI: 10.1016/s0015-0282(98)00154-x] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To determine the rates of spontaneous pregnancies among women whose infertile male partners had sperm surface antibodies. DESIGN Retrospective analysis. SETTING Infertility clinic of a university referral center. PATIENT(S) One hundred fifty-seven infertile couples; the male partner had IgA and/or IgG sperm surface antibody concentrations of >10%. INTERVENTION None. MAIN OUTCOME MEASURE(S) Spontaneous pregnancy rates (PRs) over 6 years. RESULT(S) Spontaneous PRs correlated negatively with antibody concentrations. CONCLUSION(S) Although the chance of spontaneous pregnancy among women whose partners had sperm antibody concentrations of <50% was good, intracytoplasmic sperm injection should be recommended to patients with concentrations of >90%.
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Affiliation(s)
- K Abshagen
- Institute of Reproductive Medicine, University of Münster, Germany
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Omu AE, Makhseed M, Mohammed AT, Munim RA. Characteristics of men and women with circulating antisperm antibodies in a combined infertility clinic in Kuwait. ARCHIVES OF ANDROLOGY 1997; 39:55-64. [PMID: 9202834 DOI: 10.3109/01485019708987902] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Antisperm antibodies were determined in the sera of 250 infertile couples and 100 puerperal women as controls using the immunofluorescence technique. Couples with significant circulating antisperm antibodies were placed on low-dose prednisolone 5 mg daily for 3-6 months. Initial routine semen analysis and hypoosmotic swelling test were done and repeated after 3 months of therapy. The incidence of antisperm antibodies (ASA) was 18.8 and 17.6% in the men and women, respectively, compared to 4% in the women controls (p < .02). In the men, the main determinants (with incidence) of ASA included smoking (33.9%), past history of sexually transmitted disease (33.3%), surgery to genital tract (28.6%), trauma (27.3%), and unexplained infertility (18.5%). In women whose husbands had antisperm antibodies the incidence of circulating antisperm antibodies was 38.3%, while endometriosis and thyroid dysfunction had incidence of antisperm antibodies of 21.4 and 16.7%, respectively. In the 27 (10.8%) case of unexplained infertility, the incidence of antisperm antibodies was 22.2%. High follicle-stimulating hormone (FSH) in the men and low midluteal-phase progesterone in the women were associated with increased expression of antisperm antibodies. Antisperm antibodies adversely affected quality of sperm. Low-dose prednisolone significantly reduced the titer of antisperm antibodies and improved the sperm parameters and conception rate.
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Affiliation(s)
- A E Omu
- Department of Obstetrics and Gynaecology, Faculty of Medicine, Kuwait University, Safat, Kuwait
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Räsänen M, Agrawal YP, Saarikoski S. Seminal fluid antisperm antibodies measured by direct flow cytometry do not correlate with those measured by indirect flow cytometry, the indirect immunobead test, and the indirect mixed antiglobulin reaction. Fertil Steril 1996; 65:170-5. [PMID: 8557136 DOI: 10.1016/s0015-0282(16)58047-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
OBJECTIVE To compare the direct flow cytometric (FCM) measurement of sperm-bound antibodies with the indirect FCM measurement of unbound antisperm antibodies in seminal plasma of the same ejaculates. To compare the FCM measurements with the indirect mixed antiglobulin reaction (MAR) and the indirect immunobead test (IBT) performed on the same seminal plasmas. SETTING University hospital-based infertility service. PATIENTS Eleven infertile men with a positive immunoglobulin (Ig) G direct MAR test and antibody positivity on the direct FCM measurements. Four control patients with a negative IgG-direct MAR test. MAIN OUTCOME MEASURES The proportion of spermatozoa positive for IgG and IgA antibodies as measured by various tests. RESULTS The direct and indirect FCM measurements for sperm-bound antibodies from seminal plasma did not correlate with each other. In general, IgG antibodies were not detectable by indirect FCM whereas IgA were detected in lower proportions than by direct FCM measurements. Weak correlation was observed between the indirect FCM, indirect MAR, and indirect IBT measurements. CONCLUSION Nearly all of the IgG and some of the IgA antisperm antibodies in seminal fluid bind to spermatozoa. Thus, indirect tests to measure antisperm antibodies from seminal plasma are likely to miss the presence of antisperm IgG antibodies while detecting some cases of IgA antibodies.
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Affiliation(s)
- M Räsänen
- Department of Obstetrics and Gynecology, Kuopio University Hospital, Finland
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