Shibahara Hiroaki, Shiraishi Yasuko, Hirano Yuki, Suzuki Tatsuya, Takamizawa Satoru, Suzuki Mitsuaki
Department of Obstetrics and Gynecology, Jichi Medical School, 3311-1 Yakushiji, Minamikawachi-machi, Kawachi-gun, Tochigi 329-0498, Japan.
Hum Reprod. 2003 Jul;18(7):1469-73. doi: 10.1093/humrep/deg241.
The presence of anti-sperm antibodies (ASA) in males can reduce fecundity. However, it has been shown that there is a diversity of ASA bound to the sperm surface. This study was performed to investigate the inhibitory effects on fertilization by ASA in males.
ASA were detected using the direct-immunobead test (D-IBT) in 509 semen samples. In some cases, the direct-sperm immobilization test (D-SIT) was carried out. The fertilizing ability of infertile males with ASA was determined as follows; (i) an IVF fertilization rate of >/=50%, (ii) a hemizona index (HZI) of >/=50%, and (iii) pregnancy established without the use of ART.
In total, 18 (3.54%) infertile males had ASA on the sperm surface. Except for one male with an absolute indication for ICSI because of severe asthenozoospermia and two males who dropped out of this study, fertilizing ability in 15 males could be determined. Four (26.7%) men did not satisfy the criteria. The existence of sperm immobilizing antibodies on the surface of ejaculated sperm had no impact on fertilization. In four (57.1%) of seven patients who had IB-bound sperm of >/=80%, fertilizing ability was inhibited, while none of the eight patients who had <80% IB-bound sperm had an inhibitory effect on fertilization. There was a significant difference between the two groups (P = 0.01).
Some sperm-bound antibodies are related to the inhibitory effects on fertilization, indicating that a diversity of sperm-bound antibodies exists in males. This result might be one of the reasons for the controversy of the relationship between ASA and male immunological infertility. Based on the present study, a sperm-zona pellucida binding assay should be performed for appropriate decision making in infertile males with ASA.
男性体内抗精子抗体（ASA）的存在会降低生育能力。然而，已有研究表明，精子表面结合的ASA具有多样性。本研究旨在探讨男性ASA对受精的抑制作用。
采用直接免疫珠试验（D-IBT）检测509份精液样本中的ASA。在某些情况下，进行直接精子制动试验（D-SIT）。患有ASA的不育男性的受精能力按以下标准确定：（i）体外受精（IVF）受精率≥50%；（ii）半透明带指数（HZI）≥50%；（iii）未使用辅助生殖技术（ART）而成功怀孕。
共有18名（3.54%）不育男性精子表面存在ASA。除1名因严重弱精子症有绝对指征行卵胞浆内单精子注射（ICSI）的男性和2名退出本研究的男性外，其余15名男性的受精能力得以确定。4名（26.7%）男性未达到标准。射精精子表面存在精子制动抗体对受精无影响。在7名IB结合精子≥80%的患者中，有4名（57.1%）的受精能力受到抑制，而在8名IB结合精子<80%的患者中，无一例对受精有抑制作用。两组间差异有统计学意义（P = 0.01）。
一些精子结合抗体与受精抑制作用有关，表明男性体内存在多种精子结合抗体。这一结果可能是ASA与男性免疫性不育关系存在争议的原因之一。基于本研究，对于患有ASA的不育男性，应进行精子-透明带结合试验以做出恰当决策。
