Human reproductive failure may be a consequence of aberrant expression of immunological factors during pregnancy. Although the relative importance of immunological factors in human reproduction remains controversial, substantial evidence suggests that human leukocyte antigens (HLA), antisperm antibodies, integrins, the leukaemia inhibitory factor (LIF), cytokines, antiphospholipid antibodies, endometrial adhesion factors, mucins (MUC1) and uterine natural killer cells contribute to reproductive failure. In contrast, fewer data support the roles of anti-trophoblast antibodies, anti-endometrial antibodies, T-cells, peripheral natural killer cells, anti-HLA antibodies, blocking antibodies and suppressor cells in reproductive failure. Although immunological factors involved in reproductive failure have been studied traditionally using assays for antibodies and/or antigens, detailed research on these factors demonstrates conflicting results in humans. Maternal and fetal immunology is also difficult to investigate in humans. For these reasons, molecular assays may serve as a valuable alternative to investigate how the immune system affects reproductive outcome. In Part I of this review, immunological factors involved in human reproductive failure are summarized and critically evaluated. Immunogenetic and interacting factors in human reproductive failure will be summarized and evaluated in Part II.

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Human reproductive failure I: Immunological factors

Antisperm antibodies: etiology, pathogenesis, diagnosis, and treatment

Infertility due to antisperm antibodies

A procedure for Poitou jackass sperm cryopreservation

https://www.fertstert.org/article/S0015-0282(98)00302-1/pdf

Antisperm Antibodies: Etiology, Pathogenesis, Diagnosis, and Treatment

The effect of antisperm antibodies (ASA) in males was determined in 239 men by the use of a computerized semen analyzer (CASA). ASA was assessed using the direct immunobead test (IBT). Sperm variables for men with positive ASA were significantly lower than those with negative results in percentages of motility, velocity, and linearity.

Effect of Antisperm Antibodies on Computerized Semen Analysis

The results of the sperm count, motility, and hamster oocyte penetration (SPA) tests have been found to vary greatly in individuals who have had tests performed on more than one occasion. The study presented herein was designed to evaluate the stability of the hypoosmotic swelling (HOS) test over time. A total of 444 patients were classified into categories according to the time interval between HOS tests: 0–90 days (n = 267), 91–180 days (n = 35), 181–270 days (n = 37), 271–360 days (n = 30), 1–2 years (n = 54), and >2 years (n = 21). A paired t test was used to compare mean HOS scores. The correlation between the HOS test of the first specimen and the HOS of the second specimen was calculated. For those who had 2 tests the only significant difference was found in the >2 year group (69.67 ± 9.13 vs. 64.23 ± 12.83%), p <. 05. When comparing the first and third HOS test in 74 patients, there was a significant (p <. 05) decrease in the later test when the interval was greater than 270 days. The difference w...

Stability of the hypoosmotic swelling test over time.

Therapeutic insemination by donor (TDI) was just as successful in achieving pregnancies in couples in whom the male counterparts had subnormal motile densities as in those with normal levels. All wives in this study had an infertility factor that was corrected and remained so for at least 8 months. Thus, motile density may not be a particularly good predictor of male fertility potential.

Therapeutic insemination by donor (TDI) achieves high pregnancy rates in infertile couples regardless of male motile sperm density.

The ability of the semen analysis either by routine methods (RSA) or computer-assisted means (CSA) to predict male infertility was evaluated by determining the pregnancy rates during an 8-month span in a large group of infertile couples where a female fertility factor was identified and presumably corrected. The males were untreated. Not only was CSA less effective than RSA in predicting a male infertility factor, but also neither CSA or RSA seemed capable of identifying infertility unless severely abnormal. It would appear that there is definite need to find more accurate methods of evaluating the spermiogram.

https://www.tandfonline.com/doi/pdf/10.3109/01485019008987588

Computer assisted semen analysis not superior to routine analysis in distinguishing fertile from subfertile men

Poor quality sperm motility might, in some instances, be related to a defect in the seminal fluid rather than in an intrinsic sperm defect. Three men with sperm lacking progressive forward motion (PFM), 40 min after suspension of their small antegrade fraction of a retrograde ejaculation in Ham's F-10 medium, did demonstrate sperm with PFM after suspension of the sperm in donor seminal plasma (DSP). All three achieved pregnancies following the intracervical insemination of their wives within a total of nine ovulatory cycles. Further investigation is needed to determine if the use of DSP can be applied to improve sperm motility in infertile males with a asthenozoospermia but without the complications of retrograde ejaculation. Suspension of sperm in donor seminal plasma had an enhanced effect on asthenozoospermia compared to Ham's F-10 medium in three infertile males with retrograde ejaculation and enabled them to impregnate their wives.

A. Bollendorf

Papers

Effect of Antisperm Antibodies on Computerized Semen Analysis

Stability of the hypoosmotic swelling test over time.

Therapeutic insemination by donor (TDI) achieves high pregnancy rates in infertile couples regardless of male motile sperm density.

Computer assisted semen analysis not superior to routine analysis in distinguishing fertile from subfertile men

Improved motility of retrograde ejaculates by adding donor seminal plasma.