Antisperm antibodies (ASAs) are assumed to be a possible causative factor for male infertility, with ASAs detected in 5%-15% of infertile men but in only 1%-2% of fertile ones. It remains unclear whether ASAs have an adverse effect on the outcome of in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI). This study investigated differences in the rates of fertilization, pregnancy, and live births associated with serum ASA-positive and ASA-negative men following IVF or ICSI. Five hundred and fifty-four consecutive infertile couples undergoing IVF (n = 399) or ICSI (n = 155) were included. The two-sample two-sided t-test and Chi-square or Fisher's exact test was used for statistical analysis. Lower rates of fertilization (41.7% vs 54.8%, P = 0.03), good embryos (18.9% vs 35.2%, P = 0.00), pregnancy (38.5% vs 59.4%, P = 0.00), and live births (25.8% vs 42.5%, P = 0.00) were observed in men of the IVF group with a positive serum ASA than in those with a negative ASA. ASA positivity/negativity correlated with pregnancy rates (P = 0.021, odds ratio [OR]: 0.630, 95% confidence interval [CI]: 0.425-0.932) and live birth rates (P = 0.010, OR: 1.409, 95% CI: 1.084-1.831) after controlling for the female serum follicle-stimulating hormone level and the couple's ages at IVF. Women coupled with ASA-positive men had lower live birth rates with IVF than with ICSI (25.8% and 47.4%, respectively; P = 0.07). Women coupled with ASA-positive men had lower rates of pregnancy and live births following IVF than those coupled with ASA-negative men but had a similar outcome with ICSI.
Adult ; Antibodies/pharmacology* ; Cohort Studies ; Female ; Fertilization ; Fertilization in Vitro/methods* ; Humans ; Infertility, Male/therapy* ; Live Birth ; Male ; Pregnancy ; Pregnancy Outcome ; Pregnancy Rate ; Sperm Injections, Intracytoplasmic/methods* ; Spermatozoa/immunology* ; Treatment Outcome ; Young Adult

Up to 15% of male infertility has an immunological origin, either due to repetitive infections or to autoimmune responses mainly affecting the epididymis, prostate, and testis. Clinical observations and epidemiological data clearly contradict the idea that the testis confers immune protection to the whole male genital tract. As a consequence, the epididymis, in which posttesticular spermatozoa mature and are stored, has raised some interest in recent years when it comes to its immune mechanisms. Indeed, sperm cells are produced at puberty, long after the establishment of self-tolerance, and they possess unique surface proteins that cannot be recognized as self. These are potential targets of the immune system, with the risk of inducing autoantibodies and consequently male infertility. Epididymal immunity is based on a finely tuned equilibrium between efficient immune responses to pathogens and strong tolerance to sperm cells. These processes rely on incompletely described molecules and cell types. This review compiles recent studies focusing on the immune cell types populating the epididymis, and proposes hypothetical models of the organization of epididymal immunity with a special emphasis on the immune response, while also discussing important aspects of the epididymal immune regulation such as tolerance and tumour control.
Adaptive Immunity ; Animals ; Epididymis/immunology* ; Fertility/immunology* ; Genital Neoplasms, Male/immunology* ; Humans ; Immunity, Innate ; Infertility, Male/immunology* ; Male ; Spermatozoa/immunology*

Objective: To investigate the prevalence of Ureaplasma urealyticum (UU) infection in infertile men, its influence on routine semen parameters and the distribution of antisperm antibody (AsAb) and its types in infertile patients with UU infection. METHODS: We detected the positive rate of UU infection, semen parameters, and the distribution of AsAb and its types in 662 infertile men and 25 normal fertile male controls followed by comparison of the obtained data between the two groups of subjects. RESULTS: The positive rate of UU infection was significantly higher in the infertile men than in the normal controls (52.87% ［350/662］ vs 16.00% ［4/25］, χ2 = 11.68, P <0.05). The semen volume, sperm count, sperm concentration and percentage of progressively motile sperm were remarkably lower in the UU-positive infertile males than in the control group (P <0.05). No statistically significant difference was observed between the UU-positive and UU-negative groups in the positive rates of total AsAb (43.4% vs 36.5%, χ2 = 3.25, P >0.05) and AsAb IgA, IgM and IgG in the seminal plasma, or in the percentages of serum AsAb IgM (16.9% vs 20.5%, χ2 = 1.22, P >0.05) and IgG (32.7% vs 28.9%, χ2 = 0.99, P >0.05) except in that of serum AsAb IgA (23.6% vs 17.0%, χ2 = 4.03, P <0.05). CONCLUSIONS The UU infection rate is high in infertile males, which decreases the semen volume, total sperm count, motile sperm concentration and percentage of progressively motile sperm and increases the positive rate of serum AsAb IgA.
Antibodies, Bacterial ; analysis ; Humans ; Infertility, Male ; immunology ; microbiology ; Male ; Semen ; Sperm Count ; Spermatozoa ; immunology ; Ureaplasma Infections ; diagnosis ; immunology ; Ureaplasma urealyticum ; immunology

Objective: To investigate the relationship between hepatitis B virus (HBV) infection and the incidence of male immune infertility. METHODS: Based on the levels of serum HBsAg, 3 124 infertile men were classified into an HBV-positive and an HBV-negative group and, according to the results of IBT tests, those with immune infertility were further divided into an HBV-positive and an HBV-negative group. Statistical analyses were made on the incidence rate of immune infertility and seminal parameters in the immune infertility patients of the HBV-positive and HBV-negative groups, the correlation of the number of HBV DNA copies in the serum with that in the seminal plasma of the HBV-positive patients, the association of the numbers of HBV DNA copies in the serum and seminal plasma with semen parameters, and the relationship of the number of HBV DNA copies in the seminal plasma with the incidence of immune infertility. Sperm concentration and the percentage of progressively motile sperm (PMS) were measured by computer-aided sperm analysis, sperm morphology determined by Diff-Quik staining, the level of HBsAg detected by ELISA, and the numbers of HBV DNA copies in the serum and seminal plasma calculated by RT-PCR. RESULTS: The incidence rate of immune infertility was significantly higher in the HBV-positive than in the HBV-negative group (20.3 vs 3.3%, χ2 = 187.5, P <0.01), and the percentage of morphologically normal sperm (MNS) was markedly lower in the HBV-positive than in the HBV-negative infertility patients (［3.9 ± 1.7］ vs ［6.3 ± 2.2］%, P <0.05), but no statistically significant differences were observed between the two groups of infertile males in the semen volume, sperm concentration, or PMS (P >0.05). The number of HBV DNA copies in the serum was positively correlated with that in the seminal plasma (rs = 0.86, P <0.01) while both the number of HBV DNA copies in the serum and that in the seminal plasma were negatively correlated with PMS (r = －0.233 and －0.465, P <0.01) and MNS (r = －0.250 and －0.508, P <0.01). The incidence rate of immune infertility showed no statistically significant differences among the groups with different numbers of HBV DNA copies in the seminal plasma (P >0.05). CONCLUSIONS HBV infection can increase the incidence rate of immune infertility in men and is correlated with the low quality of sperm.
Hepatitis B ; complications ; immunology ; Hepatitis B Surface Antigens ; analysis ; Hepatitis B virus ; immunology ; Humans ; Incidence ; Infertility, Male ; epidemiology ; virology ; Male ; Semen ; Semen Analysis ; Sperm Count

OBJECTIVETo detect the expressions of interleukin-6 (IL-6) and soluble intercellular adhesion molecule-1 (sI- CAM-1) in the seminal plasma of infertile men and explore the role of inflammatory cytokines in male immune infertility.

METHODSBased on the results of the sperm-bound antibody immunobead test, 123 males with clinically suspected infertility were divided into an immune infertility group (n = 41), other infertility group A (n = 37), and other infertility group B (n = 45). The immune infertility patients were further subdivided into a leukocyte-positive and a leukocyte-negative group according to the results of leukocyte peroxidase staining. The control group included 31 males confirmed to be fertilein the clinic. Statistical analyses were conducted on the differences in inflammatory cytokines expressions and main parameters in the seminal plasma among different groups. The seminal liquefaction time was measured by visual and microscopic observation, sperm concentration and motility detected using the computer-assisted sperm analysis system, sperm viability determined by hypotonic swelling assay, and the expression levels of IL-6 and sICAM-1 meas- ured by ELISA.

RESULTSThe infertility groups showed significantly lowers perm viability (P < 0.05) and progressive motility (P < 0.01) than the fertile control, but no remarkable differences from the latter in sperm concentration (P > 0.05) and semen liquefaction time (P > 0.05). No statistically significant differences were observed in seminal parameters between the immune infertility group and other infertility groups (P > 0.05). The IL-6 and sICAM-1 levels in the seminal plasma were extremely significantly higher in the im- mune infertility group ([37.92 ± 17.01] ng/L and [89.15 ± 41.82] ng/ml), other infertility group A ([22.23 ± 13.77] ng/L and [67.81 ± 33.24] ng/ml), and other infertility group B ([18.75 ± 14.32] ng/L and [53.25 ± 27.09] ng/ml) than in the normal control group ([9.47 ± 5.76] ng/L and [19.46 ± 9.77] ng/ml) (P <0.01) , with remarkable differences between the immune infertility group and the other two infertility groups (P < 0.05). The leukocyte-positive patients showed significantly increased levels of IL-6 ([49.25 ± 21.46] ng/L) and sICAM-1 ([104.36 ± 46.41] ng/ml) as compared with the leukocyte-negative ones ([31.38 ± 15.54] ng/Land [80.38 ± 35.52] ng/ml) (both P < 0.05).

CONCLUSIONIL-6 and sICAM-1 in the seminalplasma are involved in male immune infertility.

Biomarkers ; analysis ; Cytokines ; analysis ; Enzyme-Linked Immunosorbent Assay ; Humans ; Infertility, Male ; classification ; immunology ; Intercellular Adhesion Molecule-1 ; analysis ; Interleukin-6 ; analysis ; Male ; Semen ; chemistry ; immunology ; Semen Analysis ; Sperm Count ; Spermatozoa

OBJECTIVETo establish a rat model of anti-sperm antibody (AsAb)-mediated immune infertility, and investigate the effects of serum AsAb positive on the Fas/Fas-L apoptosis pathway in testis tissue and testicular germ cells of pubertal male rats.

METHODSThirty 5-week-old Wistar male rats were included in this study, 10 killed for preparation of sperm suspension, 10 as normal controls, and the other 10 made models of AsAb-positive immune infertility (experimental group). Four weeks after modeling, the testes of the rats were harvested for observation of the changes in the testis tissue under the light microscope and detection of the expressions of Fas, Fas-L and Caspase-3 proteins by immunohistochemistry.

RESULTSCompared with the control group, the experimental group showed obvious apoptotic changes in the testis tissue and remarkably increased expressions (OD value) of Fas (161.87 +/- 5.37 vs 176.97 +/- 4.58), Fas-L (150.27 +/- 8.65 vs 187.52 +/- 7.76) and Caspase-3 (120.37 +/- 6.76 vs 157.65 +/- 7.38) (P < 0.01).

CONCLUSIONSerum AsAb affected the infertility of pubertal male rats, and its mechanisms might be associated with up-regulated expression of Fas, Fas-L and Caspase-3 proteins in the Fas/Fas-L apoptotic pathway.

Animals ; Apoptosis ; Autoantibodies ; immunology ; Caspase 3 ; metabolism ; Fas Ligand Protein ; metabolism ; Germ Cells ; cytology ; immunology ; metabolism ; Infertility, Male ; Male ; Rats ; Rats, Wistar ; Signal Transduction ; Testis ; cytology ; metabolism ; fas Receptor ; metabolism

AIMTo detect the anti-follicle-stimulating hormone (FSH) antibody in idiopathic infertile patients and fertile subjects in order to determine the role of this antibody in patients with spermatogenic dysfunction.

METHODSThe anti-FSH antibody in serum was detected by an enzyme-linked immunosorbent assay (ELISA). The functional and structural integrity of the sperm membrane was evaluated with hypo-osmotic swelling (HOS) test and the ultrastructure of the spermatozoa was investigated by transmission electron microscopy (TEM).

RESULTSThe extent of positive FSH antibody in the patients with oligozoospermia and/or asthenozoospermia was significantly higher than that in the fertile subjects and infertile patients with normal sperm concentration and motility, but it was significantly lower than that in the patients with azoospermia. The extent of anti-FSH antibody in the patients with azoospermia was significantly greater than that in patients with oligospermia and/or asthenospermia, infertile people with normal sperm density and motility and fertile people. The hypo-osmotic swelling test showed that the percentage of HOS-positive spermatozoa (swollen) was 45.1 mu 3.5% in the FSH antibody-positive group and 59.1% micro 6.2% in the FSH antibody-negative control group. The percentage of functional membrane damage to spermatozoa was significantly higher in the anti-FSH antibody-positive group than in the control group. TEM showed that the outer acrosomal membrane was located far from the nucleus, and detachment of the acrosome was found in the FSH autoantibody-positive group.

CONCLUSIONThese data suggest that the presence of anti-FSH antibody is strongly correlated with the sperm quantity and quality in idiopathic male infertility. Anti-FSH antibody may be an important factor causing spermatogenic dysfunction and infertility.

Adult ; Autoantibodies ; physiology ; Cell Membrane ; immunology ; ultrastructure ; Cell Size ; Enzyme-Linked Immunosorbent Assay ; Follicle Stimulating Hormone ; immunology ; Humans ; Infertility, Male ; immunology ; Luteinizing Hormone ; blood ; Male ; Microscopy, Electron, Transmission ; Osmotic Pressure ; Semen ; cytology ; Spermatogenesis ; immunology ; Spermatozoa ; immunology ; ultrastructure

The epididymal protease inhibitor (Eppin) abounds in human semen and on the surface of human spermatozoa, specifically produced by the testis and epididymis. Recombinant Eppin has effected infertility in the immunized monkey and promises to be an effective vaccine for human immunocontraception. This article reviews the advances in the studies of Eppin gene and protein construction and its molecular mechanism of causing immunologic infertility and regulating PSA hydrolysis of Semenogelin.
Animals ; Humans ; Infertility, Male ; immunology ; Male ; Mice ; Primates ; Proteinase Inhibitory Proteins, Secretory ; chemistry ; genetics ; immunology ; physiology ; Seminal Vesicle Secretory Proteins ; physiology ; Vaccines, Contraceptive

AIMTo investigate the expression and subcellular localization of chemokine-like factor superfamily 2 (CKLFSF2) in human testis and its potential role in spermatogenesis.

METHODSA specific polyclonal antibody against CKLFSF2 was raised. The expression and cellular localization of CKLFSF2 in the seminiferous tubules was checked by immunohistochemistry method. Also, in situ hybridization was applied to localize the mRNA distribution. The EGFP-CKLFSF2 fusion protein was expressed in COS-7 cells to localize its subcellular location in vitro. In addition, the abnormal expression of CKLFSF2 in testes of patients with male infertility was assayed by reverse transcription polymerase chain reaction (RT-PCR) and immunohistochemistry methods.

RESULTSHaving a close correlation with spermatogenesis defects, CKLFSF2 was specifically expressed in meiotic and post-meiotic germ cells, which were localized to the endoplasmic reticulum (ER) near the Golgi apparatus.

CONCLUSIONCKLFSF2 could play important roles in the process of meiosis and spermiogenesis, and might be involved in the vesicular transport or membrane apposition events in the endoplasmic reticulum.

Animals ; Antibody Specificity ; COS Cells ; Cercopithecus aethiops ; Chemokines ; biosynthesis ; immunology ; Endoplasmic Reticulum ; metabolism ; Germ Cells ; metabolism ; Humans ; Immunohistochemistry ; In Situ Hybridization ; Infertility, Male ; metabolism ; MARVEL Domain-Containing Proteins ; Male ; Meiosis ; Microscopy, Confocal ; Spermatogenesis ; physiology ; Testis ; metabolism

OBJECTIVETo test anti-Sp17 antibodies in the serum of AsAb positive infertile patients, to investigate the proportion of anti-Spl7 antibodies in AsAb and their potential application to the serologic diagnosis of immune infertility and immunocontraception.

METHODSWith human recombinant Sp17 as the antigen, the ELISA method was used to detect the positive rate, antibody titre and content of anti-Sp17 antibodies in the AsAb positive serum.

RESULTSThe positive rate of anti-Sp17 antibodies in the AsAb positive serum was 56.5%, with no significant difference in the gender aspect. The percentage of anti-Sp17 antibodies in AsAb was (10.09 +/-7.45) %, with statistical significance (P <0.05).

CONCLUSIONSp17 is an important sperm antigen. Anti-Sp17 antibodies in the serum can be taken as auxiliary diagnostic index of infertility, and Sp17 is shown to be a potential candidate immunocontraception vaccine.

Adult ; Antigens, Surface ; immunology ; Autoantibodies ; blood ; Carrier Proteins ; immunology ; Contraception, Immunologic ; Female ; Humans ; Infertility, Male ; blood ; immunology ; Male ; Spermatozoa ; immunology