Immune Infertility (Immunoinfertility)

Although a relatively new finding, immune infertility is an autoimmune disease caused by antisperm antibodies (ASA). In these cases, the body considers the sperm to be “strangers” and ASAs actively bind to the sperm and kill them off or immobilize them. This leads to no sperm in the semen (azoospermia).[1] This can be found in around 5% of all sterility cases and 5-15% of all male infertility cases.[2]

Tests for Detecting ASAs

There are a few tests for detecting ASAs in the semen.

One way is a “direct” test that shows the antibodies attached to the sperm. This is called the mixed antiglobulin reaction test. (MAR Test)

Another “direct” test is the immunobead binding test (IBT) in which sperm is placed with latex beads. If the beads attach, antibodies are present in the sperm.[3]

The last and “indirect” test is the enzyme-linked immunosorbent assay (ELISA). In this test, enzymes are placed with the sperm and activity is looked at. If the enzymes react to make another product, antibodies are present.[4][5]

Treatment for Immune Infertility

Some doctors may prescribe testosterone or steroid treatment to combat this issue; however, various current research has shown it to be ineffective.[6] However, immunoinfertility in men is not a complete infertility.

In vitro fertilization (IVF) with intracytoplasmic sperm injection (ICSI) are still available as treatments. In IVF, a woman’s eggs are extracted and fertilized. After 3 or 5 days of incubation, the surviving embryos are placed back inside the woman in hopes of conception. With ICSI, an embryologist will pick one sperm to inject into the woman’s egg for fertilization. The use of ICSI can bypass the issue of sperm being unable to move through the woman’s cervical mucus to fertilize the eggs. For more information on IVF or ICSI, please visit the respective pages in the menu above.

If IVF is not possible or doesn’t work, donor sperm is available for use. This decision may be difficult for some. It is important to weigh all options and make sure to be emotionally okay with it. For more information on donor sperm, please visit the Donor page in the menu above.

[1] Hassoun, S, M Drouet, J Le Sellin, J C Bonneau, and A Sabbah. 1991. “[Immunological Causes of Male Infertility].” Allergie et Immunologie 23 (4): 121–25. http://www.ncbi.nlm.nih.gov/pubmed/2069684.

[2] “Immunology of Male Infertility.” n.d. Stony Brook Medicine. Accessed April 30, 2018. https://www.stonybrookmedicine.edu/patientcare/urology/Immunology_of_male_infertility.

[3] “Immunobead Binding.” n.d. Fertility Center of Dallas. Accessed April 30, 2018. https://fertilitycenterofdallas.com/immunobead-binding/.

[4] “Overview of ELISA.” n.d. Accessed April 30, 2018. https://www.thermofisher.com/us/en/home/life-science/protein-biology/protein-biology-learning-center/protein-biology-resource-library/pierce-protein-methods/overview-elisa.html.

[5] Naz, Rajesh K., and Walter K. H. Krause. 2015. “Role of the Immune System in Unexplained Male Infertility.” In Unexplained Infertility, 71–80. New York, NY: Springer New York. https://doi.org/10.1007/978-1-4939-2140-9_9.

[6] Baker, H W, G N Clarke, B Hudson, J C McBain, M P McGowan, and R J Pepperell. 1983. “Treatment of Sperm Autoimmunity in Men.” Clinical Reproduction and Fertility 2 (1): 55–71. http://www.ncbi.nlm.nih.gov/pubmed/6640475.