Didziokaite Gabija, Kuznecovaite Aida, Biliute Gabija, Kvedariene Violeta
Faculty of Medicine, Vilnius University, Vilnius, Lithuania.
Department of Pathology, Institute of Biomedical Sciences, Faculty of Medicine, Vilnius University, Vilnius, Lithuania.
Front Med (Lausanne). 2024 Aug 29;11:1403477. doi: 10.3389/fmed.2024.1403477. eCollection 2024.
Infertility is a pressing global public health concern, affecting millions worldwide, and the diagnosis of unexplained infertility poses particular challenges. Human seminal plasma allergy, a rarely diagnosed type I hypersensitivity reaction, emerges as a potential but often overlooked contributor to female infertility. With rare reported cases globally, the condition's low awareness and insufficient differential diagnosis may mask its actual prevalence.
This case report presents the clinical case of a 29-year-old woman with unexplained infertility who underwent two unsuccessful IVF procedures and was subsequently diagnosed with human seminal plasma allergy. The patient, known for bronchial asthma and allergic rhinitis exacerbated by inhalant allergens, exhibited eosinophilia and a history of local allergy symptoms (burning sensation, vulvar pruritus, edema, and general discomfort) as well as sneezing and nasal congestion following unprotected intercourse-symptoms compatible with human seminal plasma allergy. Molecular allergy diagnostics revealed pronounced sensitization to dust mites and Can f 5, a canine-specific allergen. A positive skin prick test using her partner's sperm confirmed the diagnosis of human seminal plasma allergy. The patient's medical history also includes mild endometriosis, raising questions about the interplay between allergic conditions and fertility. Treatment options such as barrier contraception, antihistamine therapy, and sperm desensitization are discussed.
Highlighting the need for increased awareness among healthcare professionals, this case emphasizes the significance of reporting and sharing clinical experiences to enhance our understanding of this rare condition. As researchers continue to accumulate relevant information, a more comprehensive understanding of human seminal plasma allergy and its potential impact on female fertility will contribute to improved diagnostic protocols and expanded treatment options. This case report contributes to the growing body of knowledge surrounding this rare allergy, serving as a reminder of possible intricate relationships between allergic conditions and reproductive health.
不孕症是一个紧迫的全球公共卫生问题，影响着全球数百万人，不明原因不孕症的诊断尤其具有挑战性。人类精浆过敏是一种很少被诊断出的I型超敏反应，是女性不孕症的一个潜在但常被忽视的因素。由于全球报告的病例很少，这种疾病的低知晓率和鉴别诊断不足可能掩盖了其实际患病率。
本病例报告介绍了一名29岁不明原因不孕症女性的临床病例，该患者接受了两次体外受精（IVF）手术均未成功，随后被诊断为人类精浆过敏。该患者以支气管哮喘和吸入性过敏原加重的过敏性鼻炎而闻名，表现为嗜酸性粒细胞增多，并有局部过敏症状（烧灼感、外阴瘙痒、水肿和全身不适）病史，以及无保护性交后出现打喷嚏和鼻塞——这些症状与人类精浆过敏相符。分子过敏诊断显示对尘螨和犬特异性过敏原Can f 5有明显的致敏反应。使用其伴侣的精子进行的阳性皮肤点刺试验证实了人类精浆过敏的诊断。患者的病史还包括轻度子宫内膜异位症，这引发了关于过敏状况与生育能力之间相互作用的问题。讨论了屏障避孕、抗组胺治疗和精子脱敏等治疗选择。
该病例强调了提高医疗保健专业人员认识的必要性，强调了报告和分享临床经验以增进我们对这种罕见疾病理解的重要性。随着研究人员不断积累相关信息，对人类精浆过敏及其对女性生育能力潜在影响的更全面理解将有助于改进诊断方案和扩大治疗选择。本病例报告为围绕这种罕见过敏的知识积累做出了贡献，提醒人们注意过敏状况与生殖健康之间可能存在的复杂关系。
