Chapter 126 : Autoimmunity of Testis, Ovary, and Spermatozoa

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Experimental studies indicate that infertility may have an immune basis, resulting from spontaneous or induced autoimmune disease that targets the testis, the ovary, or the spermatozoa. This chapter describes spermatozoal antibody-mediated infertility, with emphasis on the methods of sperm antibody detection with respect to the laboratory procedure, clinical indications, and interpretation of results. It focuses an emerging assay for detection of antibodies to ovarian antigens. It also discusses the human testicular and ovarian autoimmune diseases and the diagnostic dilemma they present. Autoimmunity ensues following stimulation by foreign microbial antigen that mimics gonadal antigen, when antigen is presented to T cells in the context of a vasectomy-induced granuloma, or invoked by endogenous antigen when an immunoregulatory mechanism, such as regulatory T cells, is defective. Spermatozoal antibodies may be detected in serum, or they are bound to the ejaculated spermatozoa. An important indication of the presence of antisperm antibody is an abnormal postcoital test (PCT), particularly when the semen quality is normal and the cervical mucus, obtained at late follicular phase, is well hydrated and acellular. While an abnormal PCT is suggestive of the presence of antibodies, a negative result does not preclude antibody testing. Patients with infertility for which there is not an apparent cause, despite rigorous clinical evaluation, are also candidates for antisperm antibody testing. Ovarian dysfunction is determined by abnormalities in menstrual cycle patterns and measurement of early follicularphase follicle-stimulating hormone and estradiol.

Citation: Bronson R, Luborsky J, Tung K. 2006. Autoimmunity of Testis, Ovary, and Spermatozoa, p 1116-1124. In Detrick B, Hamilton R, Folds J (ed), Manual of Molecular and Clinical Laboratory Immunology, 7th Edition. ASM Press, Washington, DC. doi: 10.1128/9781555815905.ch126
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Image of FIGURE 1

Kinetics of enzyme immunoassay reaction for ovarian antibody test. The graph compares the OD (at 405 nm) for the control average (ctrl avg) ( = 5) at each time point with the ODs of a positive control sample (POS), a negative sample (NEG), and the background (buffer) for serum dilutions of 1:100 (A) and 1:200 (B).

Citation: Bronson R, Luborsky J, Tung K. 2006. Autoimmunity of Testis, Ovary, and Spermatozoa, p 1116-1124. In Detrick B, Hamilton R, Folds J (ed), Manual of Molecular and Clinical Laboratory Immunology, 7th Edition. ASM Press, Washington, DC. doi: 10.1128/9781555815905.ch126
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