Immunological infertility in women
The diagnosis of immunological infertility in many couples who dream about their own child, causes panic. A number of questions arise: what is it, what causes, how to treat it? Try to understand.
What is immunological infertility
Externally immunological infertility often occurs without the presence of special symptoms. Men are no complaints of an erection, his body actively produces sex cells – sperm, he has a libido and a healthy sex life. His partner is also not observed problems in the sexual sphere, and it has no obvious gynecological pathology, the menstrual cycle is regular.
If such a couple with an active sex life without the use of any means of contraception for a year or more does not occur the child’s conception, can be suspected autoimmune infertility (to the exclusion of other reasons). This is a special state in which there is a lock special sperm antigens – antisperm antibodies (ASAT). They can produce both female and male body. They are present in:
- blood and plasma;
- mucous membranes;
- glands of internal secretion;
- cervical and intrauterine mucus (in women);
- semen (in men).
ASAT – are proteins-immunoglobulins that are produced by immune system to protect against foreign microorganisms. They may be present in the body of one of the partners or both at once. Such antigens adversely affect the process of conception, which is manifested by the occurrence of such diseases.
- Violation of sperm production. This leads to a decrease in their number (oligospermia), the formation of abnormal sperm (teratozoospermia), the absence in the ejaculate sperm (azoospermia).
- Damage to the functional structure of the sperm.
- The decrease in the activity of their movements.
- The lack of interaction of male and female gametes during the period of conception.
- The deterioration of the patency of the female genital tract and the male spermatic.
- Lock process of the attaching of the embryo to the uterus, leading to spontaneous miscarriage.
Antisperm antibodies attach to the sperm surface, making it difficult for them to fulfill their functional purpose. There are 3 types of ASAT depending on their localization and effects on sperm:
- Permissability (IgA) attached to the tail of the sperm, thus interfering with their normal progress.
- Spermatorrhoea (IgG) attach mainly on the head of the sperm without affecting motility. But they are able to glue them together, particles of epithelium and other cells, making it impossible for the process of conception.
- Spirolaterals (IgM) is also attached to the tail of the sperm. Antigens such men do not exist, they can exist only in a woman’s body.
The inability of conception is a fairly common anomaly in our time, and the immunological factor of infertility is about 15% of couples till 40 years.
The causes in men and women
As a rule, immunological infertility can be divided into male and female. The reason for his one – development of immune system specific proteins (immunoglobulins) that block the male sex cells (sperm), which makes impossible the process of conception.
By its nature, the sperm are alien like male and female body. Under normal circumstances they are protected by a special barrier, which is produced in the male testicles and their appendages. They are capable of mimicry, when the antigens located on the surface and perceived by the immune system as foreign microorganisms, are absorbed into the sperm (as is their masking). But with the emergence of some negative phenomena Permalink the contact of antigens with the immune system that leads to its aggression against male germ cells.
The most common factors for male immune infertility are:
- various injuries of the testicles and scrotum;
- moved surgery on the male genitals;
- the presence of chronic diseases involving inflammation (prostatitis, orchitis);
- malignant neoplasms in the pelvic area;
- infectious diseases, sexually transmitted diseases (chlamydia, gonorrhea, genital herpes, HIV and others).
Also a frequent cause of male infertility are anatomical anomalies. They include:
- varicocele (male pathology, which is characterized by varicose veins in the scrotum);
- twisting of the testicle;
- underdevelopment or obstruction of the ejaculatory channels;
- not prolapse testicles into the scrotum (cryptorchidism) and others.
For the female body, the sperm are also alien. But there is a special system of suppression of the immune protection without which the conception would not be possible. But due to certain negative factors, it ceases to perform its functions. The body produces immunoglobulins that are attached to the male sperm, leading to their total or partial immobilization and also to reduce the viability of the embryo. It becomes a cause of infertility in women.
Most often immunological infertility in many women is a consequence of such phenomena:
- Inflammation of a chronic nature in the female genital organs.
- Infectious diseases that are sexually transmitted (gonorrhea, chlamydia, genital herpes, HIV, ureaplasmosis).
- Endometriosis of the uterus. For this pathology the cells of the inner layer of the uterus grow and go beyond.
- Various allergic diseases.
- Incorrect or prolonged use of chemical contraceptives.
- Hormonal disorders while trying artificial insemination and ovarian stimulation.
- Improper insemination (artificial introduction of sperm into the uterus).
- Damage to the ovaries after the egg retrieval.
- Surgical operations on the female genital organs.
- The presence of malignancies in the pelvic organs.
The high content of antisperm antibodies trigger the immune infertility, and women indicators ASAT are: blood from 1⁄16 to 1/32, and in the mucus of the external genitalia 1⁄8. In men, these figures are much higher (blood 1/32, and in the seminal fluid of 1⁄64).
Diagnosis and treatment of
In order to diagnose immunological infertility, it is necessary to go through several stages. First and foremost, both partners need to donate blood for the presence of inflammation in the body, as well as the presence of antibodies. Then each of them needs to take the analysis the biological material on presence in it of ASAT: women explore the cervical mucus, and in men – seminal fluid. The last stage is the examination partner for compatibility.
There are several methods of such a survey:
- Sample shuvarskogo (postcoital test), which determines the compatibility of sperm and mucus from the cervix.
- MAR-test. Helps to know the number of sperm attached to antisperm antibodies. If more than half are diagnosed with infertility.
- Sample Kurzrok-Miller. Its task is to determine the ability of sperm to penetrate cervical mucus.
- Test Buvo Palmera. This cross test while you investigate the sperm of a man seeking to become a father, and a donor.
After resolution of diagnosis of infertility of immune nature, do not despair, it can be treated.
But in women be treated a little differently. It includes several procedures:
- Medication. It is aimed at removing the causes of the production of ASAT. If the woman has an infectious disease, a physician will prescribe antibiotics or antivirals to suppress the inflammatory process. If you have allergies take antihistamines. Corticosteroids are also used for correction of the immune properties of the organism.
- The use of barrier contraception (condom) for 8 to 12 months. It is necessary to exclude contact of spermatozoa with the immune system of the female body, which can significantly reduce sensitivity to male sex cells.
- The immune suppression. This woman injected allogeneic lymphocytes her partner before conception (SC) or of a mixture of plasma proteins of different men (intravenously). This allows the body to adapt and “make” male antigens.
If all methods of treatment proved ineffective, the help woman to get pregnant assisted reproductive technology. Among them:
- insemination (introduction of the husband’s sperm into the uterine cavity of women during the period of ovulation);
- EKO (artificial introduction of the already fertilized embryo).
They may appoint a doctor for specific indications after careful examination of both partners. This is the most extreme method of conception.
Immune infertility is not a sentence. It can be cured with the use of modern technology. If all methods tried and not resulted in conception, you should think about artificial insemination.