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Gupta S, Sharma R, Agarwal A, Boitrelle F, Finelli R, Farkouh A, Saleh R, Abdel-Meguid TAA, Gül M, Zilaitiene B, Ko E, Rambhatla A, Zini A, Leisegang K, Kuroda S, Henkel R, Cannarella R, Palani A, Cho CL, Ho CCK, Zylbersztejn DS, Pescatori E, Chung E, Dimitriadis F, Pinggera GM, Busetto GM, Balercia G, Salvio G, Colpi GM, Çeker G, Taniguchi H, Kandil H, Park HJ, Maldonado Rosas I, de la Rosette J, Cardoso JPG, Ramsay J, Alvarez J, Molina JMC, Khalafalla K, Bowa K, Tremellen K, Evgeni E, Rocco L, Rodriguez Peña MG, Sabbaghian M, Martinez M, Arafa M, Al-Marhoon MS, Tadros N, Garrido N, Rajmil O, Sengupta P, Vogiatzi P, Kavoussi P, Birowo P, Kosgi R, Bani-Hani S, Micic S, Parekattil S, Jindal S, Le TV, Mostafa T, Toprak T, Morimoto Y, Malhotra V, Aghamajidi A, Durairajanayagam D, Shah R. Antisperm Antibody Testing: A Comprehensive Review of Its Role in the Management of Immunological Male Infertility and Results of a Global Survey of Clinical Practices. World J Mens Health 2022; 40:380-398. [PMID: 35021297 PMCID: PMC9253805 DOI: 10.5534/wjmh.210164] [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: 07/24/2021] [Revised: 08/13/2021] [Accepted: 08/23/2021] [Indexed: 02/05/2023] Open
Abstract
Antisperm antibodies (ASA), as a cause of male infertility, have been detected in infertile males as early as 1954. Multiple causes of ASA production have been identified, and they are due to an abnormal exposure of mature germ cells to the immune system. ASA testing (with mixed anti-globulin reaction, and immunobead binding test) was described in the WHO manual 5th edition and is most recently listed among the extended semen tests in the WHO manual 6th edition. The relationship between ASA and infertility is somewhat complex. The presence of sperm agglutination, while insufficient to diagnose immunological infertility, may indicate the presence of ASA. However, ASA can also be present in the absence of any sperm agglutination. The andrological management of ASA depends on the etiology and individual practices of clinicians. In this article, we provide a comprehensive review of the causes of ASA production, its role in immunological male infertility, clinical indications of ASA testing, and the available therapeutic options. We also provide the details of laboratory procedures for assessment of ASA together with important measures for quality control. Additionally, laboratory and clinical scenarios are presented to guide the reader in the management of ASA and immunological male infertility. Furthermore, we report the results of a recent worldwide survey, conducted to gather information about clinical practices in the management of immunological male infertility.
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Affiliation(s)
- Sajal Gupta
- American Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH, USA
| | - Rakesh Sharma
- American Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH, USA
| | - Ashok Agarwal
- American Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH, USA.
| | - Florence Boitrelle
- Reproductive Biology, Fertility Preservation, Andrology, CECOS, Poissy Hospital, Poissy, France
- Paris Saclay University, UVSQ, INRAE, BREED, Jouy-en-Josas, France
| | - Renata Finelli
- American Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH, USA
| | - Ala'a Farkouh
- American Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH, USA
| | - Ramadan Saleh
- Department of Dermatology, Venereology and Andrology, Faculty of Medicine, Sohag University, Sohag, Egypt
| | - Taha Abo-Almagd Abdel-Meguid
- Department of Urology, Faculty of Medicine, Minia University, Minia, Egypt
- Department of Urology, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Murat Gül
- Department of Urology, Selcuk University School of Medicine, Konya, Turkey
| | - Birute Zilaitiene
- Institute of Endocrinology, Lithuanian University of Health Sciences, Kaunas, Lithuania, USA
| | - Edmund Ko
- Department of Urology, Loma Linda University Health, Loma Linda, CA, USA
| | - Amarnath Rambhatla
- Department of Urology, Vattikuti Urology Institute, Henry Ford Health System, Detroit, MI, USA
| | - Armand Zini
- Department of Surgery, McGill University, Montreal, QC, Canada
| | - Kristian Leisegang
- School of Natural Medicine, Faculty of Community and Health Sciences, University of the Western Cape, Bellville, South Africa
| | - Shinnosuke Kuroda
- American Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH, USA
| | - Ralf Henkel
- American Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH, USA
- Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK
- Department of Medical Bioscience, University of the Western Cape, Bellville, South Africa
- LogixX Pharma, Theale, Berkshire, UK
| | - Rossella Cannarella
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Ayad Palani
- Department of Biochemistry, College of Medicine, University of Garmian, Kalar, Iraq
| | - Chak-Lam Cho
- SH Ho Urology Center, Department of Surgery, Chinese University of Hong Kong, Hong Kong
| | - Christopher C K Ho
- Department of Surgery, School of Medicine, Faculty of Health and Medical Sciences, Taylor's University, Subang Jaya, Malaysia
| | | | | | - Eric Chung
- Department of Urology, Princess Alexandra Hospital, University of Queensland, Brisbane, QLD, Australia
| | - Fotios Dimitriadis
- 1st Urology Department, School of Medicine, Aristotle University, Thessaloniki, Greece
| | | | - Gian Maria Busetto
- Department of Urology and Organ Transplantation, Ospedali Riuniti of Foggia, University of Foggia, Foggia, Italy
| | - Giancarlo Balercia
- Department of Endocrinology and Metabolic Diseases, Polytechnic University of Marche, Ancona, Italy
| | - Gianmaria Salvio
- Department of Endocrinology and Metabolic Diseases, Polytechnic University of Marche, Ancona, Italy
| | | | - Gökhan Çeker
- Department of Urology, Samsun Vezirköprü State Hospital, Samsun, Turkey
| | - Hisanori Taniguchi
- Department of Urology and Andrology, Kansai Medical University, Hirakata, Osaka, Japan
| | | | - Hyun Jun Park
- Department of Urology, Pusan National University School of Medicine, Busan, Korea
- Medical Research Institute of Pusan National University Hospital, Busan, Korea
| | | | - Jean de la Rosette
- Department of Urology, Istanbul Medipol Mega University Hospital, Istanbul, Turkey
| | - Joao Paulo Greco Cardoso
- Divisao de Urologia, Hospital das Clínicas HCFMUSP, Universidade de Sao Paulo, São Paulo, Brazil
| | | | - Juan Alvarez
- Centro ANDROGEN, La Coruña, Spain
- Harvard Medical School, Boston, MA, USA
| | | | - Kareim Khalafalla
- Department of Urology, Hamad Medical Corporation, Doha, Qatar
- Department of Urology, University of Illinois, Chicago, IL, USA
| | - Kasonde Bowa
- School of Medicine and Health Sciences, University of Lusaka, Lusaka, Zambia
| | - Kelton Tremellen
- Department of Obstetrics Gynaecology and Reproductive Medicine, Flinders University, Bedford Park, Australia
| | | | - Lucia Rocco
- Department of Environmental, Biological and Pharmaceutical Sciences and Technologies, University of Campania "Luigi Vanvitelli", Caserta, Italy
| | | | - Marjan Sabbaghian
- Department of Andrology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
| | - Marlon Martinez
- Section of Urology, University of Santo Tomas Hospital, Manila, Philippines
| | - Mohamed Arafa
- American Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH, USA
- Department of Urology, Hamad Medical Corporation, Doha, Qatar
- Department of Urology, Weill Cornell Medical-Qatar, Doha, Qatar
| | | | - Nicholas Tadros
- Division of Urology, Southern Illinois University School of Medicine, Springfield, IL, USA
| | - Nicolas Garrido
- IVI Foundation, Instituto de Investigación Sanitaria La Fe (IIS La Fe), Valencia, Spain
| | - Osvaldo Rajmil
- Department of Andrology, Fundacio Puigvert, Barcelona, Spain
| | - Pallav Sengupta
- Department of Physiology, Faculty of Medicine, Bioscience and Nursing, MAHSA University, Jenjarom, Malaysia
| | - Paraskevi Vogiatzi
- Andromed Health & Reproduction, Fertility Diagnostics Laboratory, Maroussi, Greece
| | - Parviz Kavoussi
- Austin Fertility and Reproductive Medicine/Westlake IVF, Department of Urology, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Ponco Birowo
- Department of Urology, Cipto Mangunkusumo General Hospital, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Raghavender Kosgi
- Department of Urology and Andrology, AIG Hospitals, Gachibowli, Hyderabad, India
| | - Saleem Bani-Hani
- Department of Medical Laboratory Sciences, Faculty of Applied Medical Sciences, Jordan University of Science and Technology, Irbid, Jordan
| | - Sava Micic
- Department of Andrology, Uromedica Polyclinic, Belgrade, Serbia
| | - Sijo Parekattil
- Avant Concierge Urology & University of Central Florida, Winter Garden, FL, USA
| | - Sunil Jindal
- Department of Andrology and Reproductive Medicine, Jindal Hospital, Meerut, India
| | - Tan V Le
- Department of Andrology, Binh Dan Hospital, Ho Chi Minh City, Viet Nam
| | - Taymour Mostafa
- Department of Andrology, Sexology & STIs, Faculty of Medicina, Cairo University, Cairo, Egypt
| | - Tuncay Toprak
- Department of Urology, Fatih Sultan Mehmet Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | | | - Vineet Malhotra
- Department of Andrology and Urology, Diyos Hospital, New Delhi, India
| | - Azin Aghamajidi
- Department of Immunology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | | | - Rupin Shah
- Division of Andrology, Department of Urology, Lilavati Hospital and Research Centre, Mumbai, India
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Barbagallo F, La Vignera S, Cannarella R, Crafa A, Calogero AE, Condorelli RA. The Relationship between Seminal Fluid Hyperviscosity and Oxidative Stress: A Systematic Review. Antioxidants (Basel) 2021; 10:antiox10030356. [PMID: 33673452 PMCID: PMC7997326 DOI: 10.3390/antiox10030356] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Revised: 02/21/2021] [Accepted: 02/22/2021] [Indexed: 11/16/2022] Open
Abstract
INTRODUCTION Seminal fluid viscosity is a key parameter to achieve fertilization. Viscosity is more frequently increased in patients with infertility. However, the mechanism by which hyperviscosity causes infertility is still poorly understood. As an increased blood viscosity is associated with diseases caused by oxidative stress, it can be supposed that there is a relationship between seminal fluid viscosity and oxidative stress in male infertility. Therefore, this systematic review aims to investigate the relationship between hyperviscous seminal fluid and oxidative stress. MATERIALS AND METHODS We performed a systematic search on the following databases Pubmed, MEDLINE, Cochrane, and Scopus from the earliest available date to 10 January 2021, using Medical Subjects Headings (MeSH) indexes and keywords searches. The study included all the articles that evaluated the relationship between increased seminal fluid viscosity and oxidative stress. Article reviews even though dealing with seminal fluid hyperviscosity were excluded. RESULTS 5 articles were included in this systematic review. The results demonstrated an important impairment of antioxidant systems and increased oxidative stress in patients with high seminal fluid viscosity. CONCLUSIONS These findings suggest that a careful assessment of oxidative stress in patients with hyperviscosity may be very useful in clinical practice. Infertile patients with seminal fluid hyperviscosity could benefit from the treatment with antioxidants to protect sperm cells from oxidative damage and to improve their functional properties.
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Haghpanah A, Masjedi F, Alborzi S, Hosseinpour A, Dehghani A, Malekmakan L, Roozbeh J. Potential mechanisms of SARS-CoV-2 action on male gonadal function and fertility: Current status and future prospects. Andrologia 2020; 53:e13883. [PMID: 33108833 PMCID: PMC7645932 DOI: 10.1111/and.13883] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Revised: 09/21/2020] [Accepted: 09/27/2020] [Indexed: 02/06/2023] Open
Abstract
The novel coronavirus was recognised in December 2019 and caught humanity off guard. The virus employs the angiotensin‐converting enzyme 2 (ACE2) receptor for entry into human cells. ACE2 is expressed on different organs, which is raising concern as to whether these organs can be infected by the virus or not. The testis appears to be an organ enriched with levels of ACE2, while the possible mechanisms of involvement of the male reproductive system by SARS‐CoV‐2 are not fully elucidated. The major focus of the present studies is on the short‐term complications of the coronavirus and gains importance on studying the long‐term effects, including the possible effects of the virus on the male reproductive system. The aim of this review was to provide new insights into different possible mechanisms of involvement of male gonads with SARS‐CoV‐2 including investigating the ACE2 axis in testis, hormonal alterations in patients with COVID‐19, possible formation of anti‐sperm antibodies (ASA) and subsequently immunological infertility as a complication of SARS‐CoV‐2 infection. Finally, we suggest measuring the sperm DNA fragmentation index (DFI) as a determiner of male fertility impairment in patients with COVID‐19 along with other options such as sex‐related hormones and semen analysis. Invasion of SARS‐CoV‐2 to the spermatogonia, Leydig cells and Sertoli cells can lead to sex hormonal alteration and impaired gonadal function. Once infected, changes in ACE2 signalling pathways followed by oxidative stress and inflammation could cause spermatogenesis failure, abnormal sperm motility, DNA fragmentation and male infertility.
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Affiliation(s)
- Abdolreza Haghpanah
- Shiraz Nephro-Urology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.,Infertility Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.,Department of Urology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Fatemeh Masjedi
- Shiraz Nephro-Urology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Saeed Alborzi
- Infertility Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.,Department of Gynecology and Obstetrics, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Alireza Hosseinpour
- Shiraz Nephro-Urology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.,Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Anahita Dehghani
- Shiraz Nephro-Urology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Leila Malekmakan
- Shiraz Nephro-Urology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Jamshid Roozbeh
- Shiraz Nephro-Urology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
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Barbăroșie C, Agarwal A, Henkel R. Diagnostic value of advanced semen analysis in evaluation of male infertility. Andrologia 2020; 53:e13625. [PMID: 32458468 DOI: 10.1111/and.13625] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Revised: 04/03/2020] [Accepted: 04/08/2020] [Indexed: 12/13/2022] Open
Abstract
Conventional semen analysis is the standard of care to initially evaluate the fertility status of a male patient. However, it has some limitations and among these are failure to correctly identify the aetiology underlying fertility problems, intra- and inter-observer variability and incomplete information about sperm function. Considering these drawbacks, advanced semen tests have been developed to assess male infertility, including sperm function tests, oxidative stress (OS) and sperm DNA fragmentation (SDF) tests. This review illustrates the commonly utilised sperm function techniques, along with the assays used to assess SDF and OS and their diagnostic value.
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Affiliation(s)
- Cătălina Barbăroșie
- American Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH, USA.,Department of Genetics, Faculty of Biology, University of Bucharest, Bucharest, Romania
| | - Ashok Agarwal
- American Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH, USA
| | - Ralf Henkel
- American Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH, USA.,Department of Medical Bioscience, University of the Western Cape, Bellville, South Africa
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A. S. V, Dhama K, Chakraborty S, Abdul Samad H, K. Latheef S, Sharun K, Khurana SK, K. A, Tiwari R, Bhatt P, K. V, Chaicumpa W. Role of Antisperm Antibodies in Infertility, Pregnancy, and Potential forContraceptive and Antifertility Vaccine Designs: Research Progress and Pioneering Vision. Vaccines (Basel) 2019; 7:E116. [PMID: 31527552 PMCID: PMC6789593 DOI: 10.3390/vaccines7030116] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2019] [Revised: 08/22/2019] [Accepted: 09/04/2019] [Indexed: 02/07/2023] Open
Abstract
Sperm of humans, non-human primates, and other mammalian subjects is considered to be antigenic. The effect of changes in autoimmunity on reproductive cells such as spermatozoa and oocytes play a critical but indistinct role in fertility. Antisperm antibodies (ASAs) are invariably present in both females and males. However, the degree of ASA occurrence may vary according to individual and gender. Although the extent of infertility due to ASAs alone is yet to be determined, it has been found in almost 9-12% of patients who are infertile due to different causes. Postcoital presence of spermatozoa in the reproductive tract of women is not a contributory factor in ASA generation. However, ASA generation may be induced by trauma to the vaginal mucosa, or by anal or oral sex resulting in the deposition of sperm inside the digestive tract. It is strongly believed that, in humans and other species, at least some antibodies may bind to sperm antigens, causing infertility. This form of infertility is termed as immunological infertility, which may be accompanied by impairment of fertility, even in individuals with normozoospermia. Researchers target ASAs for two major reasons: (i) to elucidate the association between ASAs and infertility, the reason ASAs causes infertility, and the mechanism underlying ASA-mediated infertility; and (ii) to assess the potential of ASAs as a contraceptive in humans in case ASAs influences infertility. Therefore, this review explores the potential application of ASAs in the development of anti-spermatozoa vaccines for contraceptive purposes. The usefulness of ASAs for diagnosing obstructive azoospermia, salpingitis, and oligoasthenoteratozoospermia has been reviewed extensively. Important patents pertaining to potential candidates for spermatozoa-derived vaccines that may be utilized as contraceptives are discussed in depth. Antifertility vaccines, as well as treatments for ASA-related infertility, are also highlighted. This review will address many unresolved issues regarding mechanisms involving ASAs in the diagnosis, as well as prognoses, of male infertility. More documented scientific reports are cited to support the mechanisms underlying the potential role of ASA in infertility. The usefulness of sperm antigens or ASAs (recombinant) in human and wild or captive animal contraceptive vaccines has been revealed through research but is yet to be validated via clinical testing.
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Affiliation(s)
- Vickram A. S.
- Department of Biotechnology, Saveetha School of Engineering, Young Scientist DST-SERB, Govt. of India, Saveetha Institute of Technical and Medical Sciences, Chennai 600077, Tamil Nadu, India
| | - Kuldeep Dhama
- Division of Pathology, ICAR-Indian Veterinary Research Institute, Izatnagar, Bareilly 243122, Uttar Pradesh, India;
| | - Sandip Chakraborty
- Department of Veterinary Microbiology, College of Veterinary Sciences and Animal Husbandry, R.K. Nagar, West Tripura 799008, India;
| | - Hari Abdul Samad
- Division of Physiology and Climatology, ICAR-Indian Veterinary Research Institute, Izatnagar, Bareilly 243122, Uttar Pradesh, India;
| | - Shyma K. Latheef
- Division of Pathology, ICAR-Indian Veterinary Research Institute, Izatnagar, Bareilly 243122, Uttar Pradesh, India;
| | - Khan Sharun
- Division of Surgery, ICAR-Indian Veterinary Research Institute, Izatnagar, Bareilly 243122, Uttar Pradesh, India;
| | - Sandip Kumar Khurana
- ICAR-Central Institute for Research on Buffaloes, Sirsa Road, Hisar 125001, Haryana, India;
| | - Archana K.
- Department of Biotechnology, School of Biosciences and Technology, Vellore Institute of Technology, Vellore 632014, Tamil Nadu, India; (A.K.); (V.K.)
| | - Ruchi Tiwari
- Department of Veterinary Microbiology and Immunology, College of Veterinary Sciences, Deen Dayal Upadhayay Pashu Chikitsa Vigyan Vishwavidyalay Evum Go-Anusandhan Sansthan (DUVASU), Mathura 281001, India;
| | - Prakash Bhatt
- Teaching Veterinary Clinical Complex, College of Veterinary and Animal Sciences, Govind Ballabh Pant University of Agriculture and Technology, Pantnagar 263145 (Udham Singh Nagar), Uttarakhand, India;
| | - Vyshali K.
- Department of Biotechnology, School of Biosciences and Technology, Vellore Institute of Technology, Vellore 632014, Tamil Nadu, India; (A.K.); (V.K.)
| | - Wanpen Chaicumpa
- Center of Research Excellence on Therapeutic Proteinsand Antibody Engineering, Department of Parasitology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand
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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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Barbonetti A, Castellini C, D’Andrea S, Cordeschi G, Santucci R, Francavilla S, Francavilla F. Prevalence of anti-sperm antibodies and relationship of degree of sperm auto-immunization to semen parameters and post-coital test outcome: a retrospective analysis of over 10 000 men. Hum Reprod 2019; 34:834-841. [DOI: 10.1093/humrep/dez030] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Revised: 01/16/2019] [Accepted: 02/17/2019] [Indexed: 11/14/2022] Open
Affiliation(s)
- A Barbonetti
- Andrology Unit, Department of Life, Health and Environment Sciences, University of L’Aquila, L’Aquila, Italy
| | - C Castellini
- Andrology Unit, Department of Life, Health and Environment Sciences, University of L’Aquila, L’Aquila, Italy
| | - S D’Andrea
- Andrology Unit, Department of Life, Health and Environment Sciences, University of L’Aquila, L’Aquila, Italy
| | - G Cordeschi
- Andrology Unit, Department of Life, Health and Environment Sciences, University of L’Aquila, L’Aquila, Italy
| | - R Santucci
- Andrology Unit, Department of Life, Health and Environment Sciences, University of L’Aquila, L’Aquila, Italy
| | - S Francavilla
- Andrology Unit, Department of Life, Health and Environment Sciences, University of L’Aquila, L’Aquila, Italy
| | - F Francavilla
- Andrology Unit, Department of Life, Health and Environment Sciences, University of L’Aquila, L’Aquila, Italy
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8
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Berger GK, Smith‐Harrison LI, Sandlow JI. Sperm agglutination: Prevalence and contributory factors. Andrologia 2019; 51:e13254. [DOI: 10.1111/and.13254] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2018] [Revised: 01/03/2019] [Accepted: 01/27/2019] [Indexed: 11/29/2022] Open
Affiliation(s)
- Garrett K. Berger
- Department of Urology Medical College of Wisconsin Milwaukee Wisconsin
| | | | - Jay I. Sandlow
- Department of Urology Medical College of Wisconsin Milwaukee Wisconsin
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9
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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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Lotti F, Baldi E, Corona G, Lombardo F, Maseroli E, Degl’Innocenti S, Bartoli L, Maggi M. Epididymal more than testicular abnormalities are associated with the occurrence of antisperm antibodies as evaluated by the MAR test. Hum Reprod 2018; 33:1417-1429. [DOI: 10.1093/humrep/dey235] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2018] [Revised: 04/10/2018] [Accepted: 06/11/2018] [Indexed: 01/25/2023] Open
Affiliation(s)
- F Lotti
- Sexual Medicine and Andrology Unit, Department of Experimental and Clinical Biomedical Sciences ‘Mario Serio’, University of Florence, Viale Pieraccini 6, Florence, Italy
| | - E Baldi
- Sexual Medicine and Andrology Unit, Department of Experimental and Clinical Biomedical Sciences ‘Mario Serio’, University of Florence, Viale Pieraccini 6, Florence, Italy
| | - G Corona
- Sexual Medicine and Andrology Unit, Department of Experimental and Clinical Biomedical Sciences ‘Mario Serio’, University of Florence, Viale Pieraccini 6, Florence, Italy
| | - F Lombardo
- Laboratory of Seminology-Sperm Bank ‘Loredana Gandini’, Department of Experimental Medicine, University of Rome ‘La Sapienza’, Viale Regina Elena 324, Rome, Italy
| | - E Maseroli
- Sexual Medicine and Andrology Unit, Department of Experimental and Clinical Biomedical Sciences ‘Mario Serio’, University of Florence, Viale Pieraccini 6, Florence, Italy
| | - S Degl’Innocenti
- Sexual Medicine and Andrology Unit, Department of Experimental and Clinical Biomedical Sciences ‘Mario Serio’, University of Florence, Viale Pieraccini 6, Florence, Italy
| | - L Bartoli
- Sexual Medicine and Andrology Unit, Department of Experimental and Clinical Biomedical Sciences ‘Mario Serio’, University of Florence, Viale Pieraccini 6, Florence, Italy
| | - M Maggi
- Sexual Medicine and Andrology Unit, Department of Experimental and Clinical Biomedical Sciences ‘Mario Serio’, University of Florence, Viale Pieraccini 6, Florence, Italy
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11
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Jiang Y, Cui D, Du Y, Lu J, Yang L, Li J, Zhang J, Bai X. Association of anti-sperm antibodies with chronic prostatitis: A systematic review and meta-analysis. J Reprod Immunol 2016; 118:85-91. [DOI: 10.1016/j.jri.2016.09.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2015] [Revised: 07/14/2016] [Accepted: 09/14/2016] [Indexed: 11/27/2022]
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12
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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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13
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Chen X, Liu X, Ren X, Li X, Wang L, Zang W. Discovery of human posterior head 20 (hPH20) and homo sapiens sperm acrosome associated 1 (hSPACA1) immunocontraceptive epitopes and their effects on fertility in male and female mice. Reprod Fertil Dev 2016; 28:416-27. [DOI: 10.1071/rd14134] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2014] [Accepted: 06/13/2014] [Indexed: 12/30/2022] Open
Abstract
The key goals of immunocontraception research are to obtain full contraceptive effects using vaccines administered to both males and females. Current research concerning human anti-sperm contraceptive vaccines is focused on delineating infertility-related epitopes to avoid autoimmune disease. We constructed phage-display peptide libraries to select epitope peptides derived from human posterior head 20 (hPH20) and homo sapiens sperm acrosome associated 1 (hSPACA1) using sera collected from infertile women harbouring anti-sperm antibodies. Following five rounds of selection, positive colonies were reconfirmed for reactivity with the immunoinfertile sera. We biopanned and analysed the chemical properties of four epitope peptides, named P82, Sa6, Sa37 and Sa76. Synthetic peptides were made and coupled to either bovine serum albumin (BSA) or ovalbumin. We used the BSA-conjugated peptides to immunise BALB/c mice and examined the effects on fertility in female and male mice. The synthetic peptides generated a sperm-specific antibody response in female and male mice that caused a contraceptive state. The immunocontraceptive effect was reversible and, with the disappearance of peptide-specific antibodies, there was complete restoration of fertility. Vaccinations using P82, Sa6 and Sa76 peptides resulted in no apparent side effects. Thus, it is efficient and practical to identify epitope peptide candidates by phage display. These peptides may find clinical application in the specific diagnosis and treatment of male and female infertility and contraceptive vaccine development.
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14
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Ferrer M, Laflin S, Anderson D, Miesner M, Wilkerson M, George A, Miller L, Larson R, Garcia Flores E. Prevalence of bovine sperm-bound antisperm antibodies and their association with semen quality. Theriogenology 2015; 84:94-100. [DOI: 10.1016/j.theriogenology.2015.02.017] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2014] [Revised: 02/13/2015] [Accepted: 02/14/2015] [Indexed: 11/29/2022]
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15
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Cui D, Han G, Shang Y, Liu C, Xia L, Li L, Yi S. Antisperm antibodies in infertile men and their effect on semen parameters: A systematic review and meta-analysis. Clin Chim Acta 2015; 444:29-36. [DOI: 10.1016/j.cca.2015.01.033] [Citation(s) in RCA: 64] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2014] [Revised: 01/17/2015] [Accepted: 01/20/2015] [Indexed: 01/11/2023]
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16
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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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17
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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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18
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Zini A, Fahmy N, Belzile E, Ciampi A, Al-Hathal N, Kotb A. Antisperm antibodies are not associated with pregnancy rates after IVF and ICSI: systematic review and meta-analysis. Hum Reprod 2011; 26:1288-95. [DOI: 10.1093/humrep/der074] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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19
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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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20
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Zini A, Phillips S, Lefebvre J, Baazeem A, Bissonnette F, Kadoch IJ, Gabriel MS. Anti-sperm antibodies are not associated with sperm DNA damage: a prospective study of infertile men. J Reprod Immunol 2010; 85:205-8. [DOI: 10.1016/j.jri.2010.03.006] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2010] [Revised: 03/03/2010] [Accepted: 03/23/2010] [Indexed: 10/19/2022]
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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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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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23
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Djaladat H, Mehrsai A, Rezazade M, Djaladat Y, Pourmand G. Varicocele and antisperm antibody: fact or fiction? South Med J 2006; 99:44-7. [PMID: 16466121 DOI: 10.1097/01.smj.0000197036.08282.70] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To study the level of antisperm antibodies (ASAB) in the serum and semen of infertile men with varicocele before and 6 months after varicocelectomy. MATERIALS AND METHODS We performed a prospective study of 81 infertile men undergoing microsurgical inguinal varicocelectomy. Female factor was excluded. Semen analysis and seminal and serum ASAB (direct and indirect IgG and IgA), as measured by SpermMar test, were performed before and after surgery at 6 months. A control group consisting of idiopathic infertile patients was evaluated for ASAB. RESULTS Eighty-one patients with a mean age of 28.7 years (23 to 42) completed our study. Mean sperm count, motility, and abnormal forms were improved after surgery and were statistically significant for sperm density and morphology (P < 0.05). Before surgery, 21 patients (26%) had a low positivity for ASAB (10 to 40%). Six months after surgery, the ASAB titer was reduced in 15 (A group), increased in 3 (B group), and reduced in another 3 (C group). The C group also had an increase in other titers. In the A group sperm count, motility and normal forms improved after surgery (P < 0.05). In the B group, motility was reduced after surgery. In the C group, motility and normal forms were reduced after surgery. Sixty patients were negative for ASAB before surgery. Of these, 48 showed an increase in at least one of the ASAB types to some degree that had no significant effect on semen parameters. In the control group, two patients (7%) were weakly positive for ASAB. CONCLUSIONS Varicocelectomy may reduce the ASAB level, and this reduction has a good effect on semen parameter quality. Also, it may raise the ASAB level in some patients. This positive conversion has no adverse effect on semen parameters.
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Affiliation(s)
- Hooman Djaladat
- Department of Urology, Mohammadi Hospital, Hormozgan University of Medical Sciences, Tehran, Iran.
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24
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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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25
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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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26
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SINISI ANTONIOA, PASQUALI DANIELA, PAPPARELLA ALFONSO, VALENTE ANTONELLA, ORIO FRANCESCO, ESPOSITO DARIO, COBELLIS GIANNI, CUOMO ALFREDO, ANGELONE GIOVANNI, MARTONE ANTONELLO, FIORETTI GPAOLO, BELLASTELLA ANTONIO. ANTISPERM ANTIBODIES IN CRYPTORCHIDISM BEFORE AND AFTER SURGERY. J Urol 1998. [DOI: 10.1016/s0022-5347(01)62428-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- ANTONIO A. SINISI
- From the Institute of Endocrinology, Department of Medical and Surgical Pediatrics, Second University of Naples and Unit of Pediatric Surgery, Santobono Hospital and Pausillipon Hospital, Naples, Italy
| | - DANIELA PASQUALI
- From the Institute of Endocrinology, Department of Medical and Surgical Pediatrics, Second University of Naples and Unit of Pediatric Surgery, Santobono Hospital and Pausillipon Hospital, Naples, Italy
| | - ALFONSO PAPPARELLA
- From the Institute of Endocrinology, Department of Medical and Surgical Pediatrics, Second University of Naples and Unit of Pediatric Surgery, Santobono Hospital and Pausillipon Hospital, Naples, Italy
| | - ANTONELLA VALENTE
- From the Institute of Endocrinology, Department of Medical and Surgical Pediatrics, Second University of Naples and Unit of Pediatric Surgery, Santobono Hospital and Pausillipon Hospital, Naples, Italy
| | - FRANCESCO ORIO
- From the Institute of Endocrinology, Department of Medical and Surgical Pediatrics, Second University of Naples and Unit of Pediatric Surgery, Santobono Hospital and Pausillipon Hospital, Naples, Italy
| | - DARIO ESPOSITO
- From the Institute of Endocrinology, Department of Medical and Surgical Pediatrics, Second University of Naples and Unit of Pediatric Surgery, Santobono Hospital and Pausillipon Hospital, Naples, Italy
| | - GIANNI COBELLIS
- From the Institute of Endocrinology, Department of Medical and Surgical Pediatrics, Second University of Naples and Unit of Pediatric Surgery, Santobono Hospital and Pausillipon Hospital, Naples, Italy
| | - ALFREDO CUOMO
- From the Institute of Endocrinology, Department of Medical and Surgical Pediatrics, Second University of Naples and Unit of Pediatric Surgery, Santobono Hospital and Pausillipon Hospital, Naples, Italy
| | - GIOVANNI ANGELONE
- From the Institute of Endocrinology, Department of Medical and Surgical Pediatrics, Second University of Naples and Unit of Pediatric Surgery, Santobono Hospital and Pausillipon Hospital, Naples, Italy
| | - ANTONELLO MARTONE
- From the Institute of Endocrinology, Department of Medical and Surgical Pediatrics, Second University of Naples and Unit of Pediatric Surgery, Santobono Hospital and Pausillipon Hospital, Naples, Italy
| | - G. PAOLO FIORETTI
- From the Institute of Endocrinology, Department of Medical and Surgical Pediatrics, Second University of Naples and Unit of Pediatric Surgery, Santobono Hospital and Pausillipon Hospital, Naples, Italy
| | - ANTONIO BELLASTELLA
- From the Institute of Endocrinology, Department of Medical and Surgical Pediatrics, Second University of Naples and Unit of Pediatric Surgery, Santobono Hospital and Pausillipon Hospital, Naples, Italy
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27
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ANTISPERM ANTIBODIES IN CRYPTORCHIDISM BEFORE AND AFTER SURGERY. J Urol 1998. [DOI: 10.1097/00005392-199811000-00068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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28
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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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29
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Jahnukainen K, Pöllänen P, Giwercman A, Skakkebaek NE. Incidence of testicular mononuclear cell infiltrates in normal human males and in patients with germ cell neoplasia. INTERNATIONAL JOURNAL OF ANDROLOGY 1995; 18:313-20. [PMID: 8719847 DOI: 10.1111/j.1365-2605.1995.tb00568.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
The incidence of mononuclear cell (MNC) infiltrates was studied in the testes of the following: 45 patients with carcinoma in situ (CIS) as the only lesion in the testis, CIS accompanied by an early invasion of CIS or CIS accompanied by invasive germ cell tumour (GCT) of the testis; 100 men and 146 boys who had died suddenly and unexpectedly, and 100 infertility patients. The results suggest that (1) the incidence of MNC infiltration increases with increasing severity of testicular malignant changes, (2) increased MNC infiltration is also evident in the contralateral testis where no malignant cells can be observed, (3) the incidence of MNC infiltration in men who died suddenly is not different from that in men who have had their testes biopsied because of infertility, and (4) the incidence of MNC infiltration is high in testes of boys younger than 1 year of age.
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JAHNUKAINEN K, JØRGENSEN N, PÖLLÄNEN P, GIWERCMAN A, SKAKKEBÆK NE. Incidence of testicular mononuclear cell infiltrates in normal human males and in patients with germ cell neoplasia. ACTA ACUST UNITED AC 1995. [DOI: 10.1111/j.1365-2605.1995.tb00423.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Abstract
Immunoinfertility is an important problem, involving a significant number of infertile couples. Although the presence of antibodies on sperm has better prognostic value than those in serum or seminal plasma, it may not be the sole authentic evidence of immunoinfertility. Infertility from antisperm antibodies is likely only when they bind to a relevant sperm antigen involved in a specific fertility function. The variance in functional deficits seen in immunologic infertility is most likely related to antibodies directed at different sperm antigens or different class, subclass, or isotypes. Antibodies to FA-1 seem to be of significant importance in human immunoinfertility. In approaching couples with infertility, a high index of suspicion for antibodies is necessary to avoid misdiagnosis. In the optimal situation, all semen analyses should be screened for sperm-bound antibodies, but if this is impractical, testing should be performed on high-risk individuals (Table I). In couples in which the man has sperm-bound antibodies, and in whom there is no identifiable female factor, treatment should be instituted. Most treatments for immunoinfertility have been disappointing because of poor results, adverse effects, or high cost. Corticosteroid therapy has shown some promise in published reports (mostly poorly designed studies), but increase in pregnancy rate is modest and adverse effects may be significant. In our opinion, informed consent should be documented prior to institution of corticosteroid therapy, and subjects should be closely monitored. Advanced reproductive technologies offer a higher safety profile, and, with increasing technology, higher pregnancy rates. We recommend progressing from "low-tech" procedures, such as IUI and reserving the higher level procedures, such as IVF and ICSI, for those couples in whom pregnancy does not occur. The highest level reproductive technologies give the best current prospects for pregnancy in patients with this difficult problem but also are invasive and costly. It is hoped that further work in the laboratory will give rise to newer, safer, and less expensive effective treatments in the very near future.
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Affiliation(s)
- D A Ohl
- Department of Surgery, University of Michigan Medical Center, Ann Arbor 48109, USA
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Abstract
The sperm autoantigen concentration in the epididymis equals or exceeds that in the testis. This makes the epididymis a probable site of initiation of an antisperm autoimmune response. The mechanisms regulating antisperm antibody formation in the testicular excurrent ducts and some related aspects with clinical interest are reviewed.
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Affiliation(s)
- P Pöllänen
- Centre for Reproductive Medicine and Developmental Biology, University of Turku, Finland
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