Immunological disorders are considered as one of the causes of unexplained infertility, and among these, anti-sperm antibody is an important autoantibody that is involved in the etiology of immunological infertility. Anti-sperm antibody makes the egg impenetrable by sperms and blocks the fertilization process. It is also effective on the development of the fetus. On the other hand, the presence of antisperm antibodies is associated with IVF failure. Therefore, checking the presence of this antibody in IVF candidate patients seems necessary, because if this antibody is present, microinjection will be a more appropriate method. Considering that the prevalence of this antibody in follicular fluid has not been investigated, this study was conducted with the aim of investigating the prevalence of anti-sperm antibody in the follicular fluid of infertile patients.
Materials and methods:
96 infertile patients, microinjection candidates, 19-40 years old (31.5±5.1) in 96 cycles of microinjection were examined in this study. In 16 patients (16.6%) the cause of infertility is unknown and in 56% the cause of infertility is male infertility factor, in 10% infertility with tubal cause, in 7% ovarian factor, in 3% tubal factor and male factor and in 4% ovarian factor And the male factor includes the reasons for infertility. All follicular fluids were examined using this test for anti-sperm antibody. Data were analyzed using SPSS software and using T-Test, P-value less than 0.05 was considered statistically significant.
Results:
According to the cause of infertility, 56% of patients have male factor infertility, 10.4% with tubal infertility, 8.3% with ovarian factor, 4.1% with tubal factor and male factor, 5.2% with ovarian factor and male factor, 16.6% with unknown cause of infertility. have been. The results of the antisperm antibody test, in two stages using SpermMar, showed that none of the patients under study showed antisperm antibody in the follicular fluid.
Discuss:
Some studies have shown the high prevalence of immunological disorders and auto-antibodies in infertility, especially unexplained infertility, and a few limited studies have shown the high prevalence of anti-gamete antibodies in infertile patients with unknown cause.
Considering the effect of DFI in the fertilization process as well as the role of follicular fluid in the maturation and final maturation of the egg and the process of fertilization and implantation, the present study was conducted with the aim of investigating the presence and prevalence of antisperm antibodies in the follicular fluid. In fact, if antisperm antibodies are present, IUI and IVF will be beneficial. Chiu in 2003 showed that anti antibodies are present in the serum of 20% of infertile couples. Also, Naz reported the prevalence of this antibody in 36-9% of infertile patients (11). Meanwhile, DFI was not observed in any of the studied follicular fluid samples. Considering that follicular fluids have been tested with the ELISA system and also with the use of SpermMar, and then these tests were also checked with ELISA, the absence of this antibody in any of the samples can suggest two things:
1- Due to the fact that most of the previous studies were conducted on serum, the absence of this antibody in the follicular fluid of the patients under study can indicate a different prevalence of anti-sperm antibody in the follicular fluid compared to the serum.
2- The insignificant prevalence of antisperm antibody in the follicular fluid of infertile patients under study indicates the difference in the prevalence of this antibody in Iranian samples compared to foreign studies.
Considering that anti-Zona antibody in the same follicular fluid samples was investigated by the same researcher in another study and the prevalence of anti-Zona antibody in these samples was reported as 20%, it seems that the prevalence of anti-Zona antibody in follicular fluid in Compared with other immunological factors, it is less and has less clinical importance.
Conclusion: Considering the very small prevalence of DFI (sperms) in the follicular fluid of infertile patients under study, it is recommended to perform the test in a larger population with a larger number of samples with simultaneous antibody testing in follicular fluid and serum.
