Antisperm antibodies in women
These bodies participate in the process of interactionGametes (gametes), preventing spermatozoa from entering the egg shell. The mechanism by which they do this is not yet fully understood, but it is already clear that these antibodies inhibit the acrosomal response of spermatozoon cells, which acts as one of the necessary factors for successful fertilization. If one of the partners, men or women, has antispermic bodies, then the quality of the embryos is usually worse than those of people who do not have such bodies, which reduces the effectiveness of infertility treatment in vitro fertilization. If the ACAT is unsuccessfully treated with conservative techniques, the more preferred method for such pairs is the introduction of spermatozoa into the egg (ICSI).
Methods for the determination of antisperm antibodies among women
The representatives of the weaker sex antispermalAntibodies are determined in cervical mucus and in blood plasma. It is mandatory to test for the presence of such antibodies in those couples that are preparing for IVF.
Most often in the determination of antisperm antibodies, methods based on the determination of antibodies that are directed against membrane antigens are used. These include methods such as:
- Test of interaction of spermatozoa with mucosaCervix, or postcoital. It must be remembered that one of the most frequent reasons for a negative postcoital test is that there is ASAT in the sperm, that is, the problem is related to a man, not to the cervix. However, it is often possible to observe a combination of both female and male causes. The postcoital test is not very reliable when examining infertility and for him the percentage of false data is very high. This is why it is never used alone, only together with information from research on ACAT;
- MAR-test. This is a technique that allows you to determine the number of spermatozoa that are associated with antibodies of classes IgA and IgG, and also helps to know the titer of antisperm antibodies in such biological fluids as cervical mucus, spermoplasm, blood plasma. This test is recognized internationally as a diagnostic standard for ACAT, has a moderate sensitivity and high specificity;
- The latex agglutination test is a recentDeveloped and not fully tested test for ACAT. This test is a direct method of recognizing ACAT in biological fluids, such as blood plasma, sperm, cervical mucus. Has high sensitivity. The set of antibodies that can be detected using this method does not always coincide with the set of antibodies that are detected by the two previous tests, so they are usually combined to obtain more reliable results;
- ELISA (enzyme immunoassay) - most oftenUsed to search for ACAT in the blood plasma. It is considered one of the additional methods for diagnosing ACAT. Large titres of ACAT, which are determined by this method in the blood plasma in women, may not be associated with a deterioration in the onset of pregnancy.
Methods of treatment
Therapy of couples who have been identifiedIncreased level of ACAT, usually can be carried out in different ways, depending on the results of the examination. First, in most cases, a barrier method is used, that is, a condom, with constant use for a period of 2-5 months or in intermittent mode, when the condom is not used only on those days that are favorable for the appearance of pregnancy.
Reducing the amount of semen entering the body of a woman causes a decrease in the synthesis of antibodies and increases the chances of pregnancy.
Simultaneously, a treatment can be prescribed that reduces the viscosity of the cervical mucus and inhibits the synthesis of ACAT in spouses. If conservative methods do not help, then they go to ISKI.