Infertility with positive serum antisperm antibody
Introduction
Introduction to serum anti-sperm antibody-positive infertility Anti-sperm antibodies (AsAb) are a complex pathological product that can be seen by both men and women, and the exact cause is not fully understood. Men's sperm and seminal plasma are specific antigens for women. When exposed to blood, both men and women can cause an immune response, produce antibodies, prevent sperm and egg from binding, and cause infertility. basic knowledge The proportion of illness: 0.001% Susceptible people: women Mode of infection: non-infectious Complications: Infertility
Cause
Serum anti-sperm antibody-positive cause of infertility
Anti-sperm antibodies (AsAb) are common factors for infertility in men and women. According to statistics, about 20% to 40% of AsAbs are positive among infertile women. Because AsAb has the functions of killing, phagocytosis, agglutination and braking sperm, it often causes the fat egg to be combined with a fatal "frustration". It can be said that "one yang" is inseparable, and sperm entering the female reproductive tract is discouraged.
Prevention
Serum anti-sperm antibody positive infertility prevention
There is no effective preventive measure for this disease. Early detection and early diagnosis are the key to the prevention and treatment of this disease.
Complication
Serum anti-sperm antibody-positive infertility complications Complications, infertility
Chinese medicine believes that the emergence of AsAb has a certain relationship with the sinister invading the palace and the rushing. The sinister poison stays in the body, the blood is disturbed, the uterus is weak, the blood is not smooth, the sperm is inhibited or even agglutinated, and the sperm is difficult to combine or pregnant. According to the principle of combination of syndrome differentiation and disease differentiation, clinically divided into 3 types of medication.
Symptom
Serum anti-sperm antibody-positive symptoms of infertility common symptoms sperm quality decreased sperm viability low sperm quality poor anti-sperm antibody-positive uterine bleeding
The immune function of the human body is performed by hundreds of millions of different lymphocytes. Lymphocytes activated by specific antigens produce two different immune responses, humoral and cellular immune responses. Once the foreign body invades a certain part of the body, the lymphocytes are like hundreds of millions of armed fighters. Immediately, they will dispatch troops, and they will continue to move forward, and cooperate with white blood cells and macrophages until the enemy of these invasions is eliminated. However, immune responses are not always beneficial to the individual, and sometimes can cause allergic reactions. Under normal circumstances, lymphocytes have the ability to distinguish between their own tissues and foreign bodies. However, under pathological conditions, the immune recognition function is misjudged, or the human tissue undergoes some kind of change under the induction of an external cause, causing the immune system to attack the own tissue and damage and destroy its own tissue. This is an autoimmune disease such as lupus erythematosus and immune nephropathy. In addition, some tissues of the human body are isolated by a certain barrier and cannot be recognized by the immune system. For example, the antigen of sperm occurs in the late stage of the individual development and is later than the immune tolerance period, so the sperm-specific antigen has automatic and allogeneic immunogenicity. And under normal circumstances, due to anatomical reasons, sperm is isolated from the blood circulation system, never met with lymphocytes, so no immune reaction will occur. Once they meet due to genital damage or inflammation, an immune response occurs, producing anti-sperm antibodies.
Examine
Examination of serum anti-sperm antibody-positive infertility
Male examination (pay attention to the history of chronic diseases such as tuberculosis, etc.) to understand living habits and difficulty in sexual intercourse, external genital examination for abnormalities, semen examination for abnormal normal semen volume 2-6 ml, ph7.5-7.8, liquefaction The time is not more than 30 minutes, the sperm count is more than 60 million per ml, the activity number is more than 60%, the abnormal sperm is no more than 15-20%, the sperm number is less than 60 million, the fertility is poor, and the condition can be further immunized and chromosome an examination.
The woman examines the following examination in addition to the detailed examination of the medical history.
1 gynecological examination to understand the development of internal and external genital inflammation, tumors and deformities, check for galactorrhea.
2 leucorrhea check the pH of the vagina and related inflammation and sexually transmitted diseases, including trichomoniasis, Candida gonococcus and chlamydia.
3 tubal fluid examination or hysterosalpingography.
4 ovarian function tests.
a. The basal body temperature measurement was continuously measured for three months to understand the regularity of ovulation and the function of the corpus luteum.
b. Cervical mucus crystallization. Cervical mucus is thin during ovulation, which facilitates sperm penetration. The typical fern-like crystals of dentate crystals gradually decrease or disappear. Therefore, according to the change of cervical mucus crystallization in the menstrual cycle, it is helpful for diagnosis. There are no changes in ovulation and ovarian function.
c. Vaginal cytology, smear determination of hormone levels begins after menstruation is clean, once every other day until the next menstrual cramps.
d. Endometrial pathology to understand whether there is ovulation and corpus luteum function.
e. Endocrine measurement, patients with suspected pituitary, thyroid or adrenal diseases can measure pituitary gonadotropin, 17 ketone, 17 hydroxyestrogens, progesterone, oxytocin and so on. The test after sexual intercourse is best carried out two hours after sexual intercourse during ovulation. Two disinfection straws are used to absorb cervical mucus and vaginal sputum liquid. Two slides are taken for microscopic examination. All active sperm are normal, and no sperm is indicated. The man has no sperm such as sputum smear with sperm and cervical smear without sperm, indicating that the woman's cervical mucus is not normal.
Diagnosis
Diagnosis and identification of infertility with serum anti-sperm antibody positive
Differential diagnosis
Wet heat accumulation type: AsAb titer (ratio) is higher, rickets time is shorter, menstrual volume is more, and the color is darker, or there is blood clot, leucorrhea yellow, or genital itching, pelvic inflammation, or history of semen allergy, Body weight, red face red, dry mouth and thirsty, like cold food, yellow urine, stool skunk, thick and greasy tongue coating, slippery pulse or number. Treatment can be performed by clearing damp heat. This method can obviously relieve local exudation of the genital tract, avoid re-absorption of sperm antigen, and also avoid the immune response of the infectious factor to the antigen, thereby preventing the continued production of AsAb.
Internal blood stasis type: AsAb has a higher titer, longer rickets, darker menstrual color, refractory menstrual pain, or delayed menstruation, chest tightness, chest pain, menstrual breast pain, depression, abdominal distension, The tongue is dark, or the ecchymoses are seen, and the pulse string is tight or sinuous. It can be treated by promoting blood circulation and removing blood stasis. This method can improve symptoms, anti-inflammatory and antibacterial, remove AsAb in the body, improve blood circulation of the reproductive system and prevent adhesion of the reproductive tract mucosa.
Yin Huowang type: AsAb positive, longer course, early menstruation, less amount, bright red, dizziness, tinnitus, irritability, restless sleep, weak waist and knees, or heart and heart heat, palpitations, dry mouth, drink, tongue Red, less moss, fine pulse. It can be treated with nourishing yin and reducing fire. This law can play a role in helping the righteous and exorcising evil. If a large number of drugs such as prednisone are not cured, the side effects can be alleviated and the therapeutic effect is better.
