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为行卵胞浆内单精子注射(ICSI)做准备的男性中精液抗精子抗体筛查的预后价值:呼吁改变当前针对精子自身免疫检测的抗体导向观点

The prognostic value of seminal anti-sperm antibodies screening in men prepared for ICSI: a call to change the current antibody-directed viewpoint of sperm autoimmunity testing.

作者信息

El-Sherbiny Ahmed F, Ali Tamer A, Hassan Eman A, Mehaney Amira B, Elshemy Heba A

机构信息

Department of Andrology, International Islamic Center for Population Studies and Research, Al-Azhar University, Cairo, Egypt.

Al-Azhar University, Cairo, Egypt.

出版信息

Ther Adv Urol. 2021 Jan 18;13:1756287220981488. doi: 10.1177/1756287220981488. eCollection 2021 Jan-Dec.

Abstract

AIMS

We aimed to prospectively evaluate the prognostic value of seminal anti-sperm antibodies (ASA) screening in couples prepared for intracytoplasmic sperm injection (ICSI).

METHODS

A prospective comparative study was conducted, including 184 non-azoospermic infertile men scheduled for ICSI. For each patient, detection of ASA in seminal plasma using the ELISA technique was done and its relation to standard semen parameters and ICSI outcomes, including fertilization, embryo development, and pregnancy rates, was analyzed.

RESULTS

Sperm count, motility, and morphology were negatively affected by existence of seminal ASA ( = 0.012, 0.006, and 0.011, respectively). However, no statistically significant difference was detected between patients with positive and negative seminal ASA regarding the median values of fertilization (56.3% 66.7%,  = 0.091), percentage of couples with grade A embryo development (91.4% 89.9%,  = 0.520), and pregnancy rates (31.4% 32.2%,  = 0.98) after ICSI.

CONCLUSION

ICSI seems able to overcome the problem of ASA in semen. The routine screening of ASA in men prepared for ICSI has no additional prognostic value and cannot be recommended for the time being, until more specific antigen-concerned testing can be developed.

摘要

目的

我们旨在前瞻性评估精液抗精子抗体(ASA)筛查对准备接受卵胞浆内单精子注射(ICSI)的夫妇的预后价值。

方法

进行了一项前瞻性对照研究,纳入184例计划接受ICSI的非无精子症不育男性。对每位患者,采用酶联免疫吸附测定(ELISA)技术检测精浆中的ASA,并分析其与标准精液参数及ICSI结局(包括受精、胚胎发育和妊娠率)的关系。

结果

精液中ASA的存在对精子数量、活力和形态有负面影响(分别为P = 0.012、0.006和0.011)。然而,精液ASA阳性和阴性患者在ICSI后的受精中位数(56.3%对66.7%,P = 0.091)、A级胚胎发育夫妇的百分比(91.4%对89.9%,P = 0.520)和妊娠率(31.4%对32.2%,P = 0.98)方面未检测到统计学显著差异。

结论

ICSI似乎能够克服精液中ASA的问题。对于准备接受ICSI的男性,常规筛查ASA没有额外的预后价值,在能够开发出更具特异性的抗原相关检测方法之前,目前不建议进行该项筛查。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/96cb/7816526/d8599745a40e/10.1177_1756287220981488-fig1.jpg

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