Antisperm Antibodies And Fertility Challenges

Infertility is a common issue that impacts roughly 1 in 8 couples. Some reasons for infertility are easy to identify and treat. However, antisperm antibodies (ASAs) are a lesser-known reason that may require fertility treatment. ASAs are immune system proteins that target sperm cells. The proteins cause sperm to become less motile, have abnormal morphology, or clump together. Antisperm antibodies are expected to cause infertility only in specific cases by creating a unique antigen. When ASAs attach to sperm cells, the sperm cannot reach and fertilize the egg, resulting in male infertility. While ASAs are present in many individuals’ reproductive tracts, high ASAs can lead to decreased fertility.


Triggering an immune response

The presence of antisperm antibodies can be caused by a variety of factors. A common reason is a genital tract infection in either partner. Infections in the genital tract can cause the body to produce ASAs in response to the foreign antigen. Another reason is a vasectomy reversal. Some men who have undergone vasovasostomy may develop ASAs in response to the surgical procedure. In fact, any testicular trauma or surgery can lead to the creation of these antibodies in response to the resulting tissue damage. Sometimes, ASAs may develop for unknown reasons without apparent triggering factors.

Treatment for ASAs

Couples are often unaware of ASAs until a fertility clinic performs tests to confirm the presence of the proteins. From there, the medical team can suggest the best steps for pregnancy. Doctors may first recommend medication to suppress the immune system and reduce the production of ASAs. The drug can provide a window for natural conception if there are no other fertility challenges. However, there are some cases where medicine is not enough. These individuals often require assisted reproductive technology (ART) to get pregnant.

Turning to ART

When patients with ASAs pursue ART, a doctor will first try intrauterine insemination (IUI) after washing a sperm sample. IUI medically inserts a sperm sample into the cervix at the optimal time to help achieve pregnancy. If IUI is unsuccessful, the next step is in vitro fertilization (IVF), which can effectively achieve pregnancy. IVF involves fertilizing an egg in a laboratory and then transferring the embryo to the uterus. Intracytoplasmic sperm injection (ICSI) goes further by injecting a single sperm into each available egg. Sometimes, donor sperm is the only viable option for achieving pregnancy. This form of ART helps when ASAs are causing severe infertility that cannot be treated with other options.

Pregnancy is still possible

Infertility can feel overwhelming and confusing. For those with antisperm antibodies, achieving pregnancy can feel hopeless. However, once the issue is identified, a fertility clinic can help. IUI, IVF, and ICSI are the most effective options. Patients with ASAs should weigh the pros and cons of each treatment option, then make the best decision to start or grow a family.

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