1
|
Wakimoto Y, Chen Y, Honda H, Shibahara H. Advancements in the detection and implications of sperm-immobilizing antibodies in female infertility. J Reprod Immunol 2024; 164:104256. [PMID: 38797132 DOI: 10.1016/j.jri.2024.104256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2024] [Revised: 04/21/2024] [Accepted: 05/12/2024] [Indexed: 05/29/2024]
Abstract
This review highlights over five decades of research on sperm-immobilizing antibodies (SI-Abs), which are crucial for understanding female infertility due to their effects on sperm motility and fertilization. Since the 1960s, Isojima et al. have made significant strides, notably with the Sperm Immobilization Test (SIT), which revolutionized the quantification of SI-Abs and their roles in infertility. Drawing from a comprehensive PubMed search on "the sperm immobilization test" and "sperm immobilizing antibody," our review underscores the critical insights gained into SI-Abs' impact on reproductive functions. SI-Abs result from the body's response to sperm antigens, potentially leading to infertility by affecting post-intercourse sperm function. However, the presence of anti-sperm antibodies does not guarantee infertility, indicating a complex relationship between these antibodies and reproductive outcomes. Isojima et al.'s pioneering studies paved the way for SIT and sperm immobilization titer (SI50), tools that have clarified the link between SI-Abs and infertility, focusing on disrupted sperm mobility and fertilization as key infertility mechanisms. Clinically, interventions such as in-vitro fertilization (IVF), which bypasses or eliminates SI-Abs, have improved pregnancy rates, whereas Freund's complete adjuvant therapy has deepened our understanding of infertility mechanisms. The SI50 value is crucial for predicting fertility treatment success and guiding therapeutic decisions based on antibody levels. In summary, the evolution of SI-Abs research has provided new hope for addressing infertility, significantly enriching the field of reproductive immunology, and highlighting the need for ongoing investigation.
Collapse
Affiliation(s)
- Yu Wakimoto
- Department of Obstetrics and Gynecology, School of Medicine, Hyogo Medical University, 1-1 Mukogawa-cho, Nishinomiya, Hyogo 663-8501, Japan.
| | - Yuekun Chen
- Department of Obstetrics and Gynecology, School of Medicine, Hyogo Medical University, 1-1 Mukogawa-cho, Nishinomiya, Hyogo 663-8501, Japan
| | - Haruka Honda
- Department of Obstetrics and Gynecology, School of Medicine, Hyogo Medical University, 1-1 Mukogawa-cho, Nishinomiya, Hyogo 663-8501, Japan
| | - Hiroaki Shibahara
- Department of Obstetrics and Gynecology, School of Medicine, Hyogo Medical University, 1-1 Mukogawa-cho, Nishinomiya, Hyogo 663-8501, Japan
| |
Collapse
|
2
|
Leathersich S, Hart RJ. Immune infertility in men. Fertil Steril 2022; 117:1121-1131. [PMID: 35367058 DOI: 10.1016/j.fertnstert.2022.02.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Revised: 01/30/2022] [Accepted: 02/09/2022] [Indexed: 11/04/2022]
Abstract
Male factors are implicated as the cause of roughly half of cases of infertility, and the presence of antisperm antibodies (ASA) may be responsible for some of these. Their presence is associated with a reduction in natural conception and live birth and impacts the success of assisted reproductive technologies. Interpretation of the data regarding ASAs and fertility is complicated by a lack of standardization in testing methodology and test thresholds and a lack of data on their prevalence in the healthy fertile population. Although their pathogenesis remains elusive, and many cases are idiopathic, a disruption in the immunologic blood-testis barrier (BTB) appears to contribute to the formation of ASA. As delineation of the specific antigen targets of ASA advances, it has been recognized that they may affect almost all aspects of sperm function, and ASA against different targets likely have specific mechanisms of impairing fertility. Intracytoplasmic sperm injection (ICSI) appears to be the most reliable method by which to overcome fertility impairment due to ASA, achieving similar outcomes to ASA-negative patients with regard to fertilization rates, embryonic development, clinical pregnancy rates, and live birth rates. The lack of consistency in testing for and reporting ASA remains a substantial barrier to achieving clarity in describing their role in infertility and the optimal management approach, and future research should use a unified approach to the detection and description of ASA. Determination of the specific antigens targeted by ASA, and their function and clinical relevance, would contribute to improving the understanding of ASA-mediated impacts on fertility and tailoring treatment appropriately to achieve the best outcomes for patients.
Collapse
Affiliation(s)
- Sebastian Leathersich
- King Edward Memorial Hospital, Perth, Australia; Fertility Specialists of Western Australia, Claremont, Australia
| | - Roger J Hart
- King Edward Memorial Hospital, Perth, Australia; Fertility Specialists of Western Australia, Claremont, Australia; Division of Obstetrics and Gynaecology, University of Western Australia, Perth, Australia.
| |
Collapse
|
3
|
Shibahara H, Chen Y, Honda H, Wakimoto Y, Fukui A, Hasegawa A. Sex difference in anti-sperm antibodies. Reprod Med Biol 2022; 21:e12477. [PMID: 35814191 PMCID: PMC9255895 DOI: 10.1002/rmb2.12477] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Revised: 05/23/2022] [Accepted: 05/30/2022] [Indexed: 12/04/2022] Open
Abstract
Background Some diseases have sex differences. There have been no reports on the relationship between anti‐sperm antibodies (ASA) and sex differences. Methods ASA are detected by sperm‐immobilization test using patients' sera in women. In men, the ASA testing is generally performed by direct‐immunobead test. Main findings Sperm‐immobilizing antibodies in women inhibit sperm migration in their genital tract and exert inhibitory effects on fertilization. ASA bound to sperm surface in men also show inhibitory effect on sperm passage through cervical mucus. The fertilization rate of IVF significantly decreased when sperm were coated with higher numbers of ASA. For women with the antibodies, it is important to assess individual patients' SI50 titers. In patients with continuously high SI50 titers, pregnancy can be obtained only by IVF. For men with abnormal fertilizing ability by ASA, it is necessary to select intracytoplasmic sperm injection. Production of sperm‐immobilizing antibodies is likely to occur in women with particular HLA after exposure to sperm. The risk factors for ASA production in men are still controversial. Conclusion Attention to sex differences in specimens, test methods and the diagnosis of ASA should be paid. For patients with ASA, treatment strategies have been established by considering sex difference for each.
Collapse
Affiliation(s)
- Hiroaki Shibahara
- Department of Obstetrics and Gynecology School of Medicine, Hyogo Medical University Nishinomiya Japan
| | - Yuekun Chen
- Department of Obstetrics and Gynecology School of Medicine, Hyogo Medical University Nishinomiya Japan
| | - Haruka Honda
- Department of Obstetrics and Gynecology School of Medicine, Hyogo Medical University Nishinomiya Japan
| | - Yu Wakimoto
- Department of Obstetrics and Gynecology School of Medicine, Hyogo Medical University Nishinomiya Japan
| | - Atsushi Fukui
- Department of Obstetrics and Gynecology School of Medicine, Hyogo Medical University Nishinomiya Japan
| | - Akiko Hasegawa
- Department of Obstetrics and Gynecology School of Medicine, Hyogo Medical University Nishinomiya Japan
| |
Collapse
|
4
|
Wakimoto Y, Fukui A, Kojima T, Wakimoto G, Okamura N, Kamei H, Sugiyama Y, Kato T, Hasegawa A, Shibahara H. Sperm immobilization test and quantitative sperm immobilization test using frozen-thawed sperm preparation applied with computer-aided sperm analysis. Reprod Med Biol 2021; 20:321-326. [PMID: 34262400 PMCID: PMC8254177 DOI: 10.1002/rmb2.12387] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Revised: 03/31/2021] [Accepted: 04/20/2021] [Indexed: 11/28/2022] Open
Abstract
PURPOSE In a previous study, a new method was described using the sperm immobilization test (SIT) with computer-aided sperm analysis (CASA). However, obtaining high-quality sperm as needed was a known issue. Here, we compared the results of using frozen-thawed sperm and fresh sperm for the SIT using the CASA method. METHODS For the frozen-thawed preparation, 500 μL of condensed semen and 500 μL of Sperm Freeze were mixed in a cryovial and cryopreserved in liquid nitrogen. Density gradient centrifugation was used for the collection of motile sperm in both the fresh and frozen-thawed sperm preparations. A total of 50 serum samples were prepared for both the fresh and frozen-thawed sperm with each sample tested containing 10 μL of serum, 1 μL of either fresh or frozen motile sperm suspension, and 2 μL of complement. Sperm motilities were measured using CASA after a 1-hour incubation period for both fresh and frozen-thawed sperm. RESULTS Both fresh and frozen-thawed sperm reacted similarly when exposed to serum containing sperm-immobilizing antibodies asserting the use of frozen-thawed sperm for the diagnosis of immunological infertility. CONCLUSION These results suggest the possibility of using cryopreserved sperm for the SIT when fresh sperm is unavailable.
Collapse
Affiliation(s)
- Yu Wakimoto
- Department of Obstetrics and GynecologyHyogo College of MedicineNishinomiyaJapan
| | - Atsushi Fukui
- Department of Obstetrics and GynecologyHyogo College of MedicineNishinomiyaJapan
| | - Teruhito Kojima
- Department of Obstetrics and GynecologyHyogo College of MedicineNishinomiyaJapan
- Wakimoto Ob&Gyn ClinicOsakaJapan
| | - Goh Wakimoto
- Department of Obstetrics and GynecologyHyogo College of MedicineNishinomiyaJapan
- Wakimoto Ob&Gyn ClinicOsakaJapan
| | - Naoya Okamura
- Department of Obstetrics and GynecologyHyogo College of MedicineNishinomiyaJapan
| | - Hidetake Kamei
- Department of Obstetrics and GynecologyHyogo College of MedicineNishinomiyaJapan
| | - Yukiko Sugiyama
- Department of Obstetrics and GynecologyHyogo College of MedicineNishinomiyaJapan
| | - Toru Kato
- Department of Obstetrics and GynecologyHyogo College of MedicineNishinomiyaJapan
| | - Akiko Hasegawa
- Department of Obstetrics and GynecologyHyogo College of MedicineNishinomiyaJapan
| | - Hiroaki Shibahara
- Department of Obstetrics and GynecologyHyogo College of MedicineNishinomiyaJapan
| |
Collapse
|
5
|
Shibahara H, Wakimoto Y, Fukui A, Hasegawa A. Anti‐sperm antibodies and reproductive failures. Am J Reprod Immunol 2020; 85:e13337. [DOI: 10.1111/aji.13337] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Revised: 08/20/2020] [Accepted: 08/26/2020] [Indexed: 01/31/2023] Open
Affiliation(s)
- Hiroaki Shibahara
- Department of Obstetrics and Gynecology Hyogo College of Medicine Nishinomiya Japan
| | - Yu Wakimoto
- Department of Obstetrics and Gynecology Hyogo College of Medicine Nishinomiya Japan
| | - Atsushi Fukui
- Department of Obstetrics and Gynecology Hyogo College of Medicine Nishinomiya Japan
| | - Akiko Hasegawa
- Department of Obstetrics and Gynecology Hyogo College of Medicine Nishinomiya Japan
| |
Collapse
|
6
|
Wakimoto Y, Fukui A, Kojima T, Hasegawa A, Shigeta M, Shibahara H. Application of computer-aided sperm analysis (CASA) for detecting sperm-immobilizing antibody. Am J Reprod Immunol 2018; 79. [PMID: 29350445 DOI: 10.1111/aji.12814] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2017] [Accepted: 12/26/2017] [Indexed: 12/31/2022] Open
Abstract
PROBLEM Since the 1970s, anti-sperm antibodies have been studied as a pathogenic factor contributing to infertility. The complement-dependent sperm-immobilization test (SIT) and quantitative SIT have been used as effective tools for detecting anti-sperm antibodies in clinical settings. These tests have been carried out traditionally by manually counting the number of motile sperm through eye estimation. METHOD OF STUDY In this study, we developed a novel method using computer-aided sperm analysis. The results were compared with those obtained by the traditional method. RESULTS The results were identical and 25 of 78 samples tested were positive and 53 samples were negative for sperm-immobilizing (SI) antibodies based on both methods. For SI-positive samples, the values of SI50 obtained using the two methods correlated closely with high co-efficiency. CONCLUSION Using the novel method, manually counting the number of motile spermatozoa becomes unnecessary. The novel method presented here will increase the objectivity and convenience of using the SIT as a clinical indicator.
Collapse
Affiliation(s)
- Yu Wakimoto
- Department of Obstetrics and Gynecology, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan
| | - Atsushi Fukui
- Department of Obstetrics and Gynecology, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan
| | - Teruhito Kojima
- Department of Obstetrics and Gynecology, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan
| | - Akiko Hasegawa
- Department of Obstetrics and Gynecology, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan
| | | | - Hiroaki Shibahara
- Department of Obstetrics and Gynecology, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan
| |
Collapse
|
7
|
Koriyama J, Shibahara H, Ikeda T, Hirano Y, Suzuki T, Suzuki M. Toward standardization of the cut-off value for the direct immunobead test using the postcoital test in immunologically infertile males. Reprod Med Biol 2013; 12:21-25. [PMID: 29699126 PMCID: PMC5904582 DOI: 10.1007/s12522-012-0135-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2012] [Accepted: 07/26/2012] [Indexed: 10/28/2022] Open
Abstract
PURPOSE There is a need to improve our understanding of the cut-off value of the direct immunobead test (D-IBT). METHODS The subjects were 26 D-IBT-positive and 140 D-IBT-negative males. The results of post coital tests (PCTs) for each subject were examined. RESULTS A significant difference was observed in abnormal PCTs between values <20 % and those ≥20 % (P = 0.02). However, there was no significant difference in abnormal PCTs between values <50 % and those ≥50 % (P = 0.084). CONCLUSIONS A cut-off value of 20 % was correlated with the possibility of conception on treatment with IUI. The D-IBT is a screening test, and the value of 20 % initially suggested by Bronson et al. seems to be more appropriate than that of 50 % in the criteria defined by the World Health Organization.
Collapse
Affiliation(s)
- Junko Koriyama
- Department of Obstetrics and Gynecology, School of Medicine, Center for Reproductive Medicine, Jichi Medical University HospitalJichi Medical University3311‐1 Yakushiji329‐0498ShimotsukeTochigiJapan
| | - Hiroaki Shibahara
- Department of Obstetrics and Gynecology, School of Medicine, Center for Reproductive Medicine, Jichi Medical University HospitalJichi Medical University3311‐1 Yakushiji329‐0498ShimotsukeTochigiJapan
| | - Tomoe Ikeda
- Department of Obstetrics and Gynecology, School of Medicine, Center for Reproductive Medicine, Jichi Medical University HospitalJichi Medical University3311‐1 Yakushiji329‐0498ShimotsukeTochigiJapan
| | - Yuki Hirano
- Department of Obstetrics and Gynecology, School of Medicine, Center for Reproductive Medicine, Jichi Medical University HospitalJichi Medical University3311‐1 Yakushiji329‐0498ShimotsukeTochigiJapan
| | - Tatsuya Suzuki
- Department of Obstetrics and Gynecology, School of Medicine, Center for Reproductive Medicine, Jichi Medical University HospitalJichi Medical University3311‐1 Yakushiji329‐0498ShimotsukeTochigiJapan
| | - Mitsuaki Suzuki
- Department of Obstetrics and Gynecology, School of Medicine, Center for Reproductive Medicine, Jichi Medical University HospitalJichi Medical University3311‐1 Yakushiji329‐0498ShimotsukeTochigiJapan
| |
Collapse
|
8
|
Abstract
Antisperm antibodies (ASA) are one well-known cause of refractory infertility in both males and females. In females, a sperm immobilization test, which detects sperm-immobilizing antibodies indirectly in the patient's serum, requires complement for the reaction and thus seems to be a more specific immunological reaction. In males, an immunobead test or a mixed antiglobulin reaction test, which detects ASA directly on the sperm surface, is a screening test because of the nonspecific reaction.
Collapse
Affiliation(s)
- Hiroaki Shibahara
- Department of Obstetrics & Gynecology, School of Medicine, Jichi Medical University, and Center for Reproductive Medicine, Jichi Medical University Hospital, Shimotsuke, Tochigi, Japan.
| | | |
Collapse
|
9
|
Diagnosis and treatment of immunologically infertile women with sperm-immobilizing antibodies in their sera. J Reprod Immunol 2009; 83:139-44. [DOI: 10.1016/j.jri.2009.07.014] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2009] [Revised: 05/15/2009] [Accepted: 07/06/2009] [Indexed: 11/15/2022]
|
10
|
|