CLINICAL AND ANAMNESTIC CHARACTERISTICS OF DEVELOPMENT OF ANTISPERM IMMUNITY IN INFERTILE MEN.

The aim of the research was to establish connection between the roles of infertility duration, patient age, various extragenital and genital pathologies in ASA pathogenesis. The work is based on retrospective analysis of 496 outpatient cards, which covered detailed anamnestic data and results of past complex clinico-laboratory tests. Criteria for inclusion in the study was infertility during marriage for at least 18 month, high concentration of ASA-s in booth blood and sperm. It was found that there is no statistically significant connection between the ASA and past illnesses, profession, family history, accompanying autoimmune diseases and extragenital pathologies. Chlamydia trachomatis, Ureaplasma urealyticum, and Mycoplasma hominis compared to other STDs, cause statistically significant increase of ASAs concentration in blood serum, as well as in ejaculate (p<0,001). Testicle associated pathologies plays an important role in development of antisperm immunity, especially orchitis and epididymitis, during which statistically insignificant increase of levels of ASA has been detected in blood, as well as in semen (p<0,001). Thus, we can conclude that, Chlamydia trachomatis, Ureaplasma urealyticum, Mycoplasma hominis, orchitis and epididymitis causes malfunction of blood-testicular barrier, which resulted in inflammatory and toxic damage of spermatogenic epithelium, which in turn plays significant role in the development of autoimmune infertility.

Humoral immunity status if infertile men antisperm antibodies and various pathologies of reproductive organs.

The aim of the research was to study humoral immunity status of infertile men with high concentration of antisperm antibodies in blood plasma, sexually transmitted diseases (STD) and various pathologies of reproductive system. Analysis of 496 outpatient cards has been conducted. It was found, that patients with high levels of ASA >150 mg/l, or average 100-150 mg/l, had statistically significant (p=0,001) high content of Ig A and Ig G relative to the control group. Men with serum ASA concentration >100 mg/l, had statistically insignificant increased levels of all 3 types of immunoglobulins relative to the control group. Patients infected with Chlamydia trachomatis proved to have decreased IgA and IgG, 0,95±0,12 and 6,64±0,5 respectively (p<0,001). As for the patients infected with Ureaplasma urealyticum, decreased levels in Ig A and Ig M have been reported as 0,75±0,29 and 1,08±0,08 respectively (p<0,05). In the course of prostate gland inflammation statistically significant deficiency of Ig A and IgG was evident relative to the control group, 0,75±0,10 g/l and 5,94±0,54 g/l respectively (p<0,001). As for the males with varicocele, Ig A and Ig M decrease is noticeable relative to the control group, 1,06±0,21 g/l and 0,61±0,19 g/l respectively (p<0,05).