Resnick David J, Hatzis Dimitrios C, Kanganis Polly, Liccardi Frederick L, Lee-Wong Mary, Bernstein Jonathan A
The New York Presbyterian Hospital, New York, NY, USA.
Am J Reprod Immunol. 2004 Jul;52(1):42-4. doi: 10.1111/j.1600-0897.2004.00180.x.
Allergic reactions to human seminal plasma protein has become increasingly recognized in the medical community. Treatment for most allergic conditions usually begins with avoidance of the offending allergen. For women with seminal plasma protein hypersensitivity (SPH) who desire to conceive, this approach is unacceptable. We describe a case report of a woman with an SPH who desired to have unprotected intercourse in order to conceive.
The patient underwent skin prick testing to her fiancé's fresh undiluted semen. Serum-specific IgG and IgE was performed by ELISA to the fiancé's whole seminal plasma and seminal plasma proteins (SPP). The patient underwent an intravaginal graded challenge to whole seminal fluid. Intrauterine insemination with washed spermatozoa was attempted but in vitro fertilization was subsequently required.
The patient had a positive prick test to whole seminal plasma but negative specific IgG and IgE ELISA to SPPs. An intravaginal graded challenge to whole seminal plasma was well tolerated. However, she experienced a subsequent severe local reaction after unprotected intercourse. She deferred treatment with systemic desensitization to relevant SPPs. She failed intrauterine insemination but successfully conceived with in vitro fertilization.
This case report emphasizes that SPH is not associated with sterility. It also indicates that whole seminal plasma graded challenge is not uniformly successful for the treatment of SPH.
医学界越来越认识到对人类精浆蛋白的过敏反应。大多数过敏病症的治疗通常始于避免接触引发过敏的过敏原。对于渴望怀孕的精浆蛋白过敏（SPH）女性而言，这种方法是不可接受的。我们描述了一例渴望进行无保护性交以怀孕的SPH女性的病例报告。
对患者进行了针对其未婚夫新鲜未稀释精液的皮肤点刺试验。通过酶联免疫吸附测定法（ELISA）检测患者血清中针对其未婚夫全精浆和精浆蛋白（SPP）的特异性IgG和IgE。患者接受了全精液的阴道分级激发试验。尝试进行了经洗涤精子的宫内授精，但随后需要进行体外受精。
患者对全精浆的点刺试验呈阳性，但对SPP的特异性IgG和IgE ELISA检测呈阴性。对全精浆的阴道分级激发试验耐受性良好。然而，她在无保护性交后随后出现了严重的局部反应。她推迟了对相关SPP进行全身脱敏治疗。她的宫内授精失败，但通过体外受精成功受孕。
该病例报告强调SPH与不育无关。它还表明全精浆分级激发试验治疗SPH并非都能成功。
