抗精子抗体介导不育的再认识

Re-evaluation of antisperm antibodis mediating infertility

男、女性体内抗精子抗体(ASA)可以降低生育力,导致不育。但ASA介导免疫不育的关系非常复杂,目前认识仍有限。本文基于笔者30多年ASA的检测实践及以往文献审读,围绕ASA检测、ASA对睾丸精子发生、精索静脉曲张、流产的影响,以及宫腔内人工授精(IUI)、体外受精(IVF)、卵胞质内精子注射(ICSI)治疗ASA不育患者的疗效进行了评价;并针对当前ASA的阳性率、抗体水平、一般治疗效果等问题提出看法,以期增进ASA与生殖效应相互关系的深入认识。

Antisperm antibody （ASA） can reduce both male and female fertility potential, leading to infertility. However, the relationship between ASA and immune infertility is complicated, which remains many unknown problems. Based on the author＇s more than 30 years for ASA detecting practice and literature reading, in this paper, effects of ASA on spermatogenesis, varicocele, and abortion were analyzed, and clinical efficacys of infertile men or women with ASA by using intrauterine insenimation （IUI）, in vitro fertilization （IVF）, and intracytoplasmic sperm injection （ICSI） were evaluated. In addition, current state concerning ASA positive incidence, ASA level, and therapies for infertile patients with ASA were discussed. Better understanding on ASA mediated reproductive effects should be needed.