What is immune infertility? What should be checked for immune infertility?

What to check for immune infertility? Many people fail to get pregnant during the pregnancy preparation stage. Doctors will argue that it is immune infertility. Today, I will introduce to you what this disease is, what items should be checked, and what are the common treatment methods. Please see the detailed introduction below.

What is immune infertility?

1. Anti-sperm antibodies. If a woman's reproductive organs are inflamed, damaged, or if sperm is locally leaking out, the immune system will eliminate the sperm. In addition, if a woman is allergic to sperm, she may also produce sperm antibodies, which is also very frustrating.

2. Anti-endometrial antibodies. If there are a large number of immune cells in the endometrium, it is actually beneficial for embryo implantation. However, when these immune cells become abnormal, implantation will fail and lead to infertility.

3. Anti-egg antibodies: If a woman's eggs, hormones, and some secretions overflow into the reproductive tract, it may cause an autoimmune reaction, which is not conducive to the growth and development of the eggs.

What to check for immune infertility

1. Serum immune test

If the test results show positive anti-sperm antibodies in serum or cervical mucus, or positive zona pellucida antibodies, it indicates immune infertility.

2. Sperm and cervical mucus contact test

Before ovulation, collect cervical mucus and semen on a slide and observe under a microscope. If the sperm on the contact surface with the cervical mucus are seen to be trembling, inactive or moving slowly, immune infertility should be considered.

3. Cervical mucus examination

The test is performed within 2 hours of sexual intercourse before the woman ovulates. The cervical mucus and sperm survival rate in the cervix are observed, and the sperm penetration rate is tested. If there are less than 5 sperms moving vigorously in the cervical mucus per high-power field of view, it indicates that the sperm penetration rate is not up to standard, and it can be considered that immune antibodies are present.

Common treatments for immune infertility

1. For men

For infertility caused by high concentrations of sperm antibodies in the body due to male autoimmunity, the following treatment methods can be tried:

1) Immunosuppressive therapy

Use adrenal cortical hormones, either in small doses for a longer period of time, or in large doses for shock treatment, depending on the specific situation. Have sex when sperm antibodies in the body drop to a certain level to increase the chance of conception.

2) Artificial insemination

The semen is collected, and then the antibodies attached to the sperm surface are washed away with a special sperm washing solution for artificial insemination.

3) Use ketone rebound therapy

According to the physiological characteristics of testosterone, a large dose of testosterone is used to inhibit the spermatogenic epithelium first, and then the testosterone is stopped, so that the spermatogenic epithelium can produce more sperm after the inhibition is lifted. This is the testosterone rebound therapy. When the sperm count decreases, the antibody titer also decreases or disappears. Choosing to have sex after the sperm count rebounds but the antibody has not increased significantly can increase the chance of conception.

4) Treat the underlying disease

If autoimmunity is considered to be caused by inflammation such as orchitis and epididymitis, the primary disease must be actively treated at the same time.

2. For women

For immune infertility caused by antibodies in women's bodies, condom intercourse or the simultaneous use of corticosteroid immunosuppressants can be tried for treatment.

1) Avoid antigen exposure

Using condoms during each sexual intercourse can prevent further stimulation of the woman by sperm antigens. When the woman's sperm antibody level decreases, the patient is encouraged to have sex with condoms during ovulation or undergo artificial insemination.

2) Immunosuppressive methods

Adrenal cortical hormones have anti-inflammatory effects and interfere with macrophage cytotoxicity, so they can be used to treat immune infertility.

3) Intrauterine insemination

When sperm antibodies in the patient's cervical mucus interfere with fertility, the husband's semen can be processed in vitro to separate high-quality sperm for artificial insemination. This method avoids the restriction of sperm antibodies in the cervical mucus on sperm passage.

4) In vitro fertilization

The sperm and egg are cultured and fertilized in vitro, and implanted into the uterine cavity 3-5 days after fertilization. Therefore, the sperm does not need to come into contact with the female reproductive tract containing sperm antibodies before fertilization. After fertilization, due to the protective effect of the zona pellucida of the fertilized egg, the sperm antibodies cannot attack the fertilized egg, and the fertilized egg will then implant.