MАR-test and Spermiological Research Indices

Antisperm antibodies are detected in 3% to 25% of cases in men and women diagnosed with infertility. They can also be diagnosed in 1–10% of healthy fertile men. The presence of a high titer of AST is one of the factors of male infertility, which can be «hidden», i. e. not cause symptoms and deterioration of the overall spermogram. The objective: to analyze the results of sperm testing in men with antisperm antibodies, which were detected by MAR-test. Material and methods. A retrospective analysis of the examination results of 555 men was conducted on the basis of the Medical Center for Infertility Treatment in Chernivtsi. Spermograms were examined according to WHO recommendations in 2000, using an inverted microscope Olympus CKX41 in a Broker chamber. Determination of the percentage of sperm coated with antisperm antibodies was performed using the MAR-test (MAR-test, MAR-mixed antiglobulin reaction). Results. If we calculate the percentage of patients in whom we assume the connection between the presence of antisperm antibodies and undertaken surgery, genital infections and allergy history, we get only 48.3% of cases. It has been found that most changes in sperm counts correlate with the percentage of sperm that are coated with IgG. These data indicate that increased IgG levels play an important role in the development of pathospermia. A negative medium-strength correlation was found between the percentage of Category A sperm and the percentage of IgG-coated sperm. Persistence of IgG in semen is accompanied by a probable decrease in the morphological quality of sperm. Conclusion. In 52% of patients it was not possible to establish the etiological factor for the presence of Ig in the ejaculate. It has been found that most changes in sperm counts correlate with the percentage of sperm that are coated with IgG. It has been determined that an increase in the level of IgA and IgG leads to a probable increase in the percentage of pathological sperm forms and decrease in sperm motility. In the presence of 30% of sperm that are coated with IgG, with a probability of 95%, the ejaculate of patients will have 100% of pathologicoalr mf s of sperm.

The impact of antisperm antibodies on human male reproductive function: an update

Immune infertility occurs due to the presence of antisperm antibodies (ASA). This type of infertility has a relatively low prevalence (2.6-6.6% in infertile men), and its etiology, risk factors, targets and consequences for male fertility are not completely understood. While it is largely accepted that abnormalities in the blood-testis barrier and/or blood-epididymal barrier are the main factors behind its etiology, and that sperm motility is the most frequently reported altered parameter, few are the well-defined risk factors and ASA targets only now started to be disclosed, with proteins involved in sperm-oocyte interaction rising as the most significant. The development of potential treatments is also limited, being the corticosteroids the more promising. Overall, there are still many knowledge gaps related to immune infertility. With this review we aimed to gather all the information collected from studies developed in humans in the last decade. Despite the controversial results/inconsistencies, that are not only a result from the complexity of mechanisms/variables involved in ASA infertility, but also from the technical approaches to assess ASA and the lack of a consensus regarding the thresholds to be used, this manuscript aims to bring a fresh update on the field. It has become clear that, to obtain more/reliable data, there is a need to assess ASA in all the routine seminal analysis, following WHO recommendations. In this way it will be possible to obtain consistent and comparable information, that can add to current knowledge. Additionally, multicentric studies with large cohorts are also missing, and future research should take this into consideration.

FORMATION OF MALE FERTILITY IN ONTOGENESIS

The main human species mission is fertility, which is an important point of the concept of health in general and of reproductive health in particular. Endocrinologists, obstetrician-gynaecologists, urologists and paediatricians are focused in this field of medicine. A decline in male fertility of up to 30–35% results in infertility which becomes serious concerns growing for human population. Many of the problems that lead to impaired male fertility are rooted in childhood, or rather, in prenatal ontogenesis. The penetration of vascular-bed substances into the cavity of the seminiferous tubules depends on the maturity and functional status of the structures constituting the blood-testicular barrier (BTB). A breach of BTB results in damage to the sperm epithelium and, as a consequence, in different grades of impairment of spermatogenesis. Among the diseases that predispose men to infertility varicocele predominates (up to 30%). One of the reasons for infertility is the impaired integrity of BTB when the process of spermatogenesis changes, sometimes in combination with infection, trauma, and toxic effects. Given the unfavorable prognosis of the consequences of these diseases in children, their careful and timely diagnosis is important. Fertility estimation places special emphasis on the state of BTB, which can be determined by the content of claudine-11, antisperm antibodies, inhibin B, and other markers.

Sperm Parameters, ASAs and Apoptosis After Processing by the Double Tube and Swim up Methods

The aim of this study was to improve the quality of semen samples by using a novel double-tube (DT) method. The DT method was developed to select sperm and compared with traditional swim-up (SU) technique for 31 semen samples. Sperm DNA integrity were tested with TUNEL and SCSA. Content of antisperm antibodies (ASA) in the semen was measured by ELISA and MAR. Levels of the caspase-3 in the sperm were assessed by western blotting. After SU and DT, 15 couples and 16 couples were underwent IVF-ET. The number of RCDs, the percentage of SDF and DFI, ASA and the level of caspase-3 were significantly decreased after DT and SU ( p = .001 and p < .001). When the DT and SU compared, there were significant changes in the number of RCD, the percentage of SDF and DFI, ASA and the level of caspase-3 ( p < 0.05-0.001). There was a higher cleavage rate ( p = .017) and a lower abortion rate ( p < .05) in DT-IVF group than in SU-IVF group. DT selection yielded spermatozoa with low RCDs, DFI, ASA, and caspase-3 which would be benefit for ART.