Treatment of immune infertility

Abstract

Immune infertility due to antisperm antibodies (ASA) is an important cause of infertility in humans. The incidence of ASA in infertile couples is 9-36% depending on the reporting center. ASA directed against the fertilization- related antigens are more relevant to infertility than the immunoglobulin binding to sperm antigens that do not play a role in fertility. Several methods have been reported for the treatment of immunoinfertility. These include immunosuppressive therapies using corticosteroids or cyclosporine; assisted reproductive technologies (ART) such as intrauterine insemination (IUI), gamete intrafallopian transfer (GIFT), in vitro fertilization (IVF), and intracytoplasmic sperm injection (ICSI); and laboratory techniques such as sperm washing, immunomagnetic sperm separation, proteolytic enzyme treatment, and immunobeads usage. Some of these available techniques have side effects; others are invasive and expensive with low efficacy and provide conflicting results. Recent findings on delineating sperm antigens that have a role in fertilization/fertility may provide novel modalities for treatment. © 2009 Springer-Verlag Berlin Heidelberg.