10% to 20% of infertility cases are immune infertility.
The main treatment methods are:
①Isolation therapy. After women with sperm alloimmune infertility use condoms for 3 to 6 months, they can avoid further stimulation of the woman by sperm antigens. After the antibody titer disappears, she can expect to get pregnant if she chooses to have sex during ovulation.
②Immunosuppressive therapy. Adrenocortical hormone drugs can be used to treat immune infertility, such as prednisone 5 mg, 3 times a day, two weeks before ovulation. There have also been reports of topical vaginal application of hydrocortisone in the treatment of infertile women with antisperm antibodies in their cervical mucus. According to reports, the pregnancy rate ranges from 20% to 45%.
③Intrauterine artificial insemination. When there are sperm antibodies in the cervical mucus that interfere with conception, the husband\’s semen can be processed outside the body and high-quality sperm can be isolated for intrauterine artificial insemination.
④In vitro fertilization. If a woman continues to have high titers of anti-sperm antibodies, she is an indication for in vitro fertilization. It has been reported that using in vitro fertilization and embryo transfer technology for immune infertile patients, the fertilization rate reached 83% and the pregnancy rate reached 33%.
Immune infertility is not easy to diagnose and treat. This cause is usually considered only after other possible causes of infertility have been ruled out. The theory is that some men\’s sperm have an immune response to themselves and produce anti-sperm antibodies. This antibody sticks to sperm, preventing them from moving through the cervical mucus and preventing them from penetrating the egg cell. If more than 80% of sperm are affected, it can lead to infertility.
Since sperm are produced long after birth, there seems to be a protective mechanism that protects sperm from intrusion. If this protective system fails, antisperm antibodies can damage sperm. Factors that may lead to failure of the protective system include inflammation of the testicles,Cancer, testicles not descending into the scrotum, varicocele, testicular damage, biopsies and vasectomy, etc. However, the causal relationship between the above factors and the failure of the protective system has not been completely confirmed, and there is no doubt that the occurrence of these symptoms is related to the anti-sperm antibodies that adhere to the sperm.
There is still some controversy and uncertainty in the medical community about the diagnosis and treatment of this disease. Sperm test analysis shows that the sperm are gathered together instead of separated, or the sperm move slowly. Therefore, after ruling out other factors that cause infertility, anti-sperm antibodies can be considered to be at play. Researchers listed the following indicators of immune infertility: ① exclude all other factors that may cause infertility; ② insufficient cervical mucus; ③ semen laboratory analysis shows that sperm are clustered together instead of separated; ④ sperm move slowly or not at all. move.
There are many ways to test sperm for the presence of antibodies, but their accuracy varies from laboratory to laboratory. Test results should be verified by a specialist who treats male infertility before proceeding with treatment.
Only men whose reproductive systems are not blocked and whose spouses have had a comprehensive examination, or those who meet the above indicators, are considered for treatment. Under normal circumstances, if the anti-sperm antibody test of a male patient shows that more than 50% of the sperm is affected, the patient should receive treatment. Experiments have found that sperm carrying a small amount of antibodies have the same effect after sexual intercourse as sperm carrying no antibodies.
Steroid therapy is a treatment method that reduces the production of antibodies and weakens the adhesion of antibodies. However, its treatment results are unreliable. Studies of more than a dozen cases treated with different doses of steroids have shown pregnancy rates ranging from 6% to 50%.
Intrauterine insemination has always been a good way to overcome the lack of sperm motility and the inability of some sperm to penetrate cervical mucus due to the influence of antibodies. Although this method is expensive, it is less risky than steroid therapy. However, the number of people using intrauterine insemination to treat immune infertility is small. Its success rate is low and its effectiveness is variable.
Assisted reproductive technologies such as in vitro fertilization, fertilized egg transplantation, fallopian tube fertilization, and gamete intrafallopian transplantation can also overcome immune infertility and have a certain success rate. The advantage of in vitro fertilization and fertilized egg implantation and fallopian tube fertilization is that it can confirm whether the fertilized egg was fertilized by sperm carrying antibodies before it is transplanted into the uterus or fallopian tube. The effectiveness of these assisted reproductive technologies depends on the proportion of sperm carrying antibodies. Research on in vitro fertilization shows that if the number of sperm carrying antibodies by the man accounts for more than 80% of the total, the pregnancy rate is higher.
This article is provided by Baidu Reading and is excerpted from \”The Clear \”Conception\” Plan\” Author: Sun Jianqiu and Xie Yingbiao