肥胖及超重不孕妇女抗精子抗体的评价

Evaluation of antisperm antibody in infertile women with obesity or overweight

目的通过观察肥胖及超重不孕妇女血清抗精子抗体(ASA)水平,探讨ASA是否介导了肥胖不孕妇女的生育力下降。方法收集2017年2~12月于深圳市龙岗区妇幼保健院生殖内分泌科就诊的190例不孕妇女为研究对象,按照体重指数(BMI)不同分成3组:体重正常组(A组):BMI≤24kg/m^2,90例;超重组(B组):24kg/m^2<BMI<28kg/m^2,62例;肥胖组(C组):BMI≥28kg/m^2,38例。采用间接免疫珠试验(iIBT)检测3组患者血清标本中ASA-IgG和ASA-IgA水平,以黏附免疫珠的活动精子数>50%为阳性,20%~49%为弱阳性,<20%为阴性,观察各组患者ASA-IgG和ASA-IgA的阳性率。结果 A组90例患者中检出1例ASA-IgG阳性者,阳性率为1.1%;B、C组中未检出ASA-IgG阳性者。A、B和C组分别检出2例、1例和1例ASA-IgG弱阳性者,弱阳性率分别为2.2%、1.6%和2.6%,3组弱阳性率比较无显著差异(P>0.05)。3组均未检出ASA-IgA阳性者。结论 ASA不是介导肥胖不孕妇女生育力下降的主要因素。

Objective：To investigate the level of the serum antisperm antibody（ASA）in infertile women with obesity or overweight to clarify whether ASA mediates the decline in fertility of such infertile women.Methods： A total of 190 infertile women aged 26-35 years were divided into 3 groups according to the body mass index（BMI）：group A（BMI≤24;n=90）,group B（24〈BMI〈28;n=62）and group C（BMI≥28;n=38）.The ASA type IgG and IgA in serum were screened by the indirect immunobead test according to the WHO laboratory manual.50% or more of motile sperm adherence to the immunoglobulin was regarded as clinical positivity;20%to 49% motile was sub-positive;Less than 20% was negative.Results：One case was detected to be ASA-IgG positive（1.1%）in group A.No case showed the clinical positive level in groups B and C.Two cases（2.2%）in group A,1 case in group B（1.6%）and 1 case（2.6%）in group C were ASA-IgG sub-positive,and the sub-positive incidence was not significantly different among the three groups（P〉0.05）.ASA-IgA was not detected in all the three groups.Conclusions：ASA is not associated with the etiology of infertile women with obesity or overweight.