Antisperm antibodies in women with unexplained infertility

ABSTRACT

Unexplained infertility occurs in many couples of childbearing age, immune mechanisms have been postulated in this disorder for the last few decades. Circulating antibodies against spermatozoa present in serum and seminal plasma have been especially implicated. This autoimmunity against spermatozoa has been investigated in males, while the isoimmunity [in the females] has got low attention. Fifty women with unexplained infertility and twenty fertile women were involved in this case-control study. ELISA test was used to detect antisperm antibody [ASA] from cervical mucus [CM] and serum specimens of both groups of women. CM was collected at mid-cycle period and dissolved mechanically [not by bromeline]. Thirty percent of infertile women have IgG-ASA in their serum and 20% have IgA-ASA in the CM, while 22% of fertile women have IgG-ASA in their serum and no fertile women have any titer of IgA-ASA in their CM specimens. Only CM-IgA-ASA of infertile women showed significant statistical correlation with cellular property of CM, which was scored according to Insler score. It is concluded that ELISA test is more sensitive and specific than microagglutination tests for detection of serum and secreted ASA. Also, secretory IgA-ASA are more indicative amid have potential role in immunological infertility as iso- immunity than IgG-ASA. Therefore, it is strongly recommended that immunological infertility should be considered as an important cause of infertility and have to gain a special interest by clinicians