immune infertility
Introduction
Introduction to immune infertility Immune infertility is a relative concept, which means that immunity reduces fertility and temporarily leads to infertility. The persistence of infertility depends on the interaction between immunity and fertility. If immunity is stronger than fertility, infertility occurs. If the latter is stronger than the former, pregnancy occurs. About 10-30% of infertility patients, including anti-sperm antibodies, anti-endometrial antibodies, anti-oval antibodies, and other types of immune infertility. The most common clinically seen is the immune infertility caused by the production of anti-sperm antibodies. Refers to infertile women, cervical mucosa, endometrium containing immunoglobulin G, A lymphoid cells appear abnormal, resulting in female infertility. basic knowledge The proportion of sickness: 0.01% Susceptible people: women Mode of infection: non-infectious Complications: infertility
Cause
Immune infertility
Endocrine factors (30%)
Anti-Zona pellucida antibodies cover the sperm receptors on the zona pellucida, so that sperm can not recognize their own receptors, and thus can not bind to the egg. The antibody can stabilize the surface structure of the transparent belt, thereby resisting the dissolution of the sperm acrosome enzyme on the zona pellucida, so that the sperm cannot penetrate the zona pellucida. If it has been fertilized, due to the stability of the zona pellucida structure, the embryo is enclosed in a transparent belt and cannot be implanted.
Self-factor (25%)
Sperm and its antigen can be engulfed by macrophages and intraepithelial Langhans cells in the vagina and cervix, and the sperm antigen and the helper lymphocytes immunologically induce and activate the production of immunocompetent cells. The latter is transported to the reproductive tract by the blood to kill sperm and reduce the survival rate of sperm. It has been reported that the mechanism of anti-sperm antibody-induced infertility is to inhibit sperm penetration of cervical mucus, kill sperm and reduce sperm survival rate, or inhibit sperm capacitation, acrosome reaction and fertilization. Therefore, it is considered that dysfunction of cervical immunology is also one of the important reasons for female infertility.
Environmental factors (15%)
Sexual intercourse is also an important reason for inducing women's immune infertility. Contains a variety of proteins in sperm and semen. For some women who have a specific immune response, if they repeatedly and repeatedly contact their husband's sperm and semen, these heterologous proteins are absorbed as an antigenic substance by the female reproductive tract. It is easy to stimulate the production of anti-sperm antibodies in the body.
Prevention
Immune infertility prevention
Women should insist on drinking milk, eat high-calcium food such as fish and shrimp, insist on exercising, improve the body's immunity, and prepare for pregnancy.
2. Avoid infection with chlamydia.
3. Pay attention to rest.
4, to avoid sexual life and chaotic life.
5, female friends should quit smoking and reduce second-hand smoke inhalation.
6. Avoid mental stress and adjust your emotions.
Complication
Immune infertility complications Complications infertility
1. Killing sperm or affecting sperm activity may also have a certain effect on sperm metabolism and sperm contractile protein function.
2, affecting the activity of sperm enzymes, inhibiting the dispersion of zona pellucida and radioactive crowns, including: 1 acrosome protease; 2 sperm hyaluronidase.
3. Affect embryo development.
4. Close the transparent band identification point on the acrosomal membrane to inhibit the adhesion and penetration of the sperm to the transparent band.
Symptom
Immune infertility symptoms common symptoms secondary infertility female infertility male infertility
I. Alloimmunization
The sperm and seminal plasma of the man act as antigens to produce antibodies in the woman's body, causing the sperm to agglutinate or to lose the activity of the sperm.
Second, local immunity
Some infertile women have cervical mucosa and endometrium containing lymphoid cells producing immunoglobulins G and A, which contain anti-sperm immunoglobulins G, A and M. Therefore, the cervix and female reproductive tract have a local immune effect on sperm.
Third, autoimmune
Male sperm, seminal plasma or female eggs, reproductive tract secretions, hormones and other spilled genital tract into their surrounding tissues, causing their own body's immune response, producing corresponding antibody substances in the body, affecting sperm vitality or follicular maturation and ovulation.
Examine
Immune infertility check
Female immune infertility examination
Cervical mucus contact test, cervical mucus test, ovarian pituitary function test, reproductive immunology test, tubal patency test, endometrial pathology test, immunological test, cervical mucus test
Male immunological infertility check item
1, history check
If the patient has genetic problems, whether there is cryptorchidism, orchitis, or orchitis caused by mumps, is it common to eat cottonseed oil and wear tight pants.
2, body examination
Check the size, hardness and elasticity of the testis, whether the vas deferens is patency or not, and whether the functions of the prostate and seminal vesicles are normal.
3, immune factor check
Diagnosis
Immune infertility diagnosis and identification
Diagnostic criteria
(1) Infertility period is more than 3 years.
(2) Excluding other causes of infertility.
(3) A reliable test method confirms the presence of anti-fertility antibodies in the body.
(4) In vitro experiments confirmed that anti-fertility immunity interferes with human sperm-egg binding.
Diagnosis method
1 sperm agglutination test; 2 mixed agglutination test; 3 sperm brake test; 4 enzyme-linked immunosorbent assay; 5 immunofluorescence test; 6 anti-globulin radioimmunoassay; 7 immunobead binding test.
