This term is typically applied to sperm antibodies. Antibodies are proteins produced by our immune system that circulate through the bloodstream and into body organs to fight off infection and cancer cells. However, sometimes these antibodies are mistakenly created against normal cells or tissues, and they are then called an auto-immune response. One such case that can complicate human fertility is the occurrence of sperm antibodies. Certain conditions such as varicocele, undescended testes, testicular torsion, testis trauma or persistent low motility after successful vasectomy reversal have all been associated with the development of sperm antibodies. However, in most cases there is no obvious cause other than an irregularity of the immune system.
Sperm antibodies when present at higher levels can negatively impact fertility by immobilizing sperm or preventing the sperm from penetrating the egg. Sperm antibodies have been primarily detected in semen, on the sperm surface, in blood samples and in the female partner's cervical mucus. Sperm antibodies are primarily anticipated in cases of isolated sperm motility issues in screening semen analyses and when immobilized sperm are seen in an abnormal cervical mucus sample taken after intercourse at the time of ovulation (post coital test). The most common tests for sperm antibodies are done directly on the sperm, Direct Immunobead Test (DIBT), or indirectly from the blood or seminal fluid of the man or from the blood or cervical mucus of the female partner, Indirect Immunobead Test (IIBT).
Treatment of sperm antibodies can be accomplished by treatment of the male or female partner with oral pill mild to moderate immunosuppressive agents such as Prednisone. Effectiveness of treatment is noted by improvement in sperm motility in follow up semen analyses or by improvement in follow up post coital tests, and ultimately by achieving pregnancy. Alternately, laboratory processing of the semen sample to remove sperm antibodies (Sperm Wash) has been combined with intra-uterine insemination of the female partner (IUI) to bypass sperm antibody related motility problems. When egg penetration impairment due to sperm antibodies is suspected and treatment of the man with prednisone has not been effective, this problem can be bypassed by a special type of in vitro fertilization combined with direct injection of single sperm into the egg under highly specialized laboratory conditions (IVF-ICSI).
