How to care for antisperm antibodies

Patient's question:

Detailed medical condition and consultation purpose: Infertility for two years after marriage, with normal sexual life
Duration and course of the current illness:
Auxiliary tests: Ovulation is present, the uterus is normal

Doctor's answer:

If anti-sperm antibodies are detected during infertility testing, the first step should be to avoid antigen stimulation. The commonly used methods include the use of condoms for local isolation, or discontinuing sexual intercourse or coitus interruptus for contraception for 6 months to prevent sperm from contacting the female reproductive tract, thereby avoiding the continuous production of anti-sperm antibodies in the female body. After rechecking a negative antibody result, sexual intercourse during the ovulation period has a pregnancy rate of 50%. If the anti-sperm antibodies remain positive, the pregnancy rate is only about 10%. It can be combined with other treatment methods. Immunosuppressants, including local therapy, low-dose continuous therapy, and high-dose intermittent administration, can also be used.
For patients with anti-sperm antibodies present in cervical mucus, local therapy is applied, such as placing hydrocortisone suppositories into the vagina. For patients with positive serum anti-sperm antibodies and oligospermia, low-dose therapy can be used, such as taking 5mg of prednisone daily for 3 to 12 months, which may help improve sperm count. High-dose intermittent therapy has more severe side effects and is suitable for cases where the husband's sperm count and other indicators are normal, and the wife has confirmed normal ovulation. Methylprednisolone 32mg, taken three times a day, for 7 consecutive days (administered on days 21–28 or 1–7 of the wife's menstrual cycle), can be repeated for 6 months. The pregnancy rates of various treatment methods range between 10% and 30%, with no significant differences.
In recent years, assisted reproductive technologies have been applied to patients with immunological infertility. For those who do not respond to the above treatments, artificial insemination and in vitro fertilization-embryo transfer can bring hope to infertile patients.