Simpson J L, Carson S A, Mills J L, Conley M R, Aarons J, Holmes L B, Jovanovic-Peterson L, Knopp R, Metzger B
Department of Obstetrics and Gynecology, University of Tennessee, Memphia, USA.
Fertil Steril. 1996 Jul;66(1):36-42. doi: 10.1016/s0015-0282(16)58384-8.
To obtain prospective data on the relationship between presence of antisperm antibodies in maternal sera and first trimester pregnancy losses.
First trimester sera obtained from diabetic and nondiabetic women recruited within 21 days of conception were analyzed using the indirect immunobead test for immunoglobulin (Ig)G, IgA, and IgM antisperm antibodies. Regional binding also was considered: sperm head, midpiece, and sperm tail. Results were correlated with pregnancy outcome.
Five university centers.
One hundred eleven women who experienced pregnancy loss (55 diabetic; 56 nondiabetic) were matched 2:1 with 104 diabetic and 116 nondiabetic women (controls) who subsequently had a normal liveborn infant.
None.
Pregnancy outcome (spontaneous abortion, liveborn) correlated with presence or absence of antisperm antibodies.
Analyzing samples without knowledge of clinical status, no differences were observed with respect to IgG, IgA, and IgM binding when a positive test was defined as 50% of sperm showing antibody binding. Likewise, no association was found for IgG and IgM antisperm antibodies at 20% binding. The only positive finding was observed for IgA antisperm antibodies at 20% binding (Fisher's Exact test). This one positive finding merely could reflect multiple comparisons. No significant differences between groups were observed when analysis was stratified according to location of antibody binding (head, midpiece, tail tip, entire sperm). When the sample was stratified into those having and not having a prior loss, a relationship between antisperm antibodies and pregnancy loss still was not evident.
Further work is necessary to determine whether IgA antisperm antibodies truly are associated with pregnancy loss or whether antisperm antibodies play any role in repetitive aborters. Findings in this study suggest that antisperm antibodies do not play a major role in pregnancy loss.
获取关于孕妇血清中抗精子抗体的存在与孕早期妊娠丢失之间关系的前瞻性数据。
采用间接免疫珠试验分析在受孕21天内招募的糖尿病和非糖尿病女性的孕早期血清，检测免疫球蛋白（Ig）G、IgA和IgM抗精子抗体。还考虑了区域结合情况：精子头部、中段和精子尾部。结果与妊娠结局相关。
五个大学中心。
111名经历过妊娠丢失的女性（55名糖尿病患者；56名非糖尿病患者）与104名糖尿病女性和116名非糖尿病女性（对照组）按2:1进行匹配，对照组随后产下正常活婴。
无。
妊娠结局（自然流产、活产）与抗精子抗体的存在与否相关。
在不知道临床状况的情况下分析样本，当阳性检测定义为50%的精子显示抗体结合时，IgG、IgA和IgM结合方面未观察到差异。同样，在20%结合率时，未发现IgG和IgM抗精子抗体有相关性。唯一的阳性发现是在20%结合率时的IgA抗精子抗体（Fisher精确检验）。这一阳性发现可能仅反映了多次比较。根据抗体结合位置（头部、中段、尾尖、整个精子）进行分层分析时，各组之间未观察到显著差异。当样本分为有过和没有过既往妊娠丢失的两组时，抗精子抗体与妊娠丢失之间的关系仍然不明显。
需要进一步研究以确定IgA抗精子抗体是否真的与妊娠丢失有关，或者抗精子抗体在反复流产者中是否起任何作用。本研究结果表明抗精子抗体在妊娠丢失中不发挥主要作用。
