Immunology and immupathology of male genital tract. Antisperm immunity in natural and assisted reproduction

Research conducted in the last 40 years has provided evidence that antisperm antibodies (ASA) can impair the fertilizing capacity of human spermatozoa. It is established that ASA can be present at different sites, can act against different antigens and can impair fertility in various ways. In fact, in the past it was amply demonstrated that ASA can act negatively on sperm motility and on cervical mucus penetration. In recent years, owing to the improvement and spreading of IVF techniques, it has been possible to demonstrate the effect of antibody-bound spermatozoa at the level of in-vitro gamete interaction. The literature demonstrates that the various previously used treatments for immunological infertility, i.e. medical therapy, intrauterine insemination with husband's spermatozoa (AIH) and IVF, usually had poor success. The primary choice of treatment in immunological infertility, especially in the most severe cases and when the sperm head is involved, is ICSI. ASA evaluation in all couples who undergo the various techniques of insemination or IVF is imperative.