Jiang Huan, Zhu Wei-Jie
Institute of Reproductive Immunology, College of Life Science and Technology, Jinan University, Guangzhou, PR China.
Urol Int. 2013;90(4):470-4. doi: 10.1159/000348824. Epub 2013 Apr 18.
Infertility in adulthood is a well-recognized consequence of cryptorchidism, even after successful orchidopexy. Autoimmune reactions against spermatozoa are associated with infertility and often found in cryptorchids. The purposes of this study were to evaluate the linkage between antisperm antibody (ASA) and cryptorchidism, and furthermore, to clarify whether ASA is involved in cryptorchidism-associated infertility.
We investigated a total of 48 infertile males with a history of unilateral (n = 30) or bilateral (n = 18) cryptorchidism who had undergone successful orchidopexy in prepuberty, and 20 age-matched fertile and healthy males were collected as controls. ASA in sperm samples was detected by the direct immunobead test, and semen analysis was performed concomitantly.
No infertile case satisfied the diagnostic criteria of ASA-mediated infertility set forth by the World Health Organization. Decreases in both sperm concentration and motility accompanied by increases in abnormal morphology were seen in infertile cryptorchids when compared with the healthy controls.
Testicular heat exposure in prepuberty is not a risk factor for ASA production. It is evident that the mechanisms that underlie cryptorchidism-associated infertility do not involve ASA. Poor sperm characteristics in cryptorchids resulting from thermal damage to the testes seem to be responsible for their infertility, even after successful orchidopexy.
成年期不育是隐睾症公认的后果，即使在成功进行睾丸固定术后也是如此。针对精子的自身免疫反应与不育相关，且常在隐睾症患者中发现。本研究的目的是评估抗精子抗体（ASA）与隐睾症之间的联系，此外，阐明ASA是否参与隐睾症相关的不育。
我们共调查了48例有单侧（n = 30）或双侧（n = 18）隐睾症病史且在青春期前成功进行睾丸固定术的不育男性，并收集了20例年龄匹配的生育能力正常且健康的男性作为对照。通过直接免疫珠试验检测精子样本中的ASA，并同时进行精液分析。
没有不育病例符合世界卫生组织制定的ASA介导的不育诊断标准。与健康对照相比，不育的隐睾症患者精子浓度和活力降低，同时异常形态增加。
青春期前睾丸受热不是产生ASA的危险因素。显然，隐睾症相关不育的潜在机制不涉及ASA。即使在成功进行睾丸固定术后，睾丸因热损伤导致的隐睾症患者精子特征不佳似乎是其不育的原因。
