Patient's question:
Doctor: Hello! I previously had antisperm antibodies, which later turned negative and I got pregnant, but the fetus stopped developing at three months of pregnancy. Now I am preparing to get pregnant again, but have not been able to conceive for six months. I have mild-moderate cervical erosion and have had antisperm antibodies. I heard that a post-coital test can be done. Could you please tell me which hospitals in Shanghai can perform this test, what the approximate cost is, and what precautions need to be taken? Is it treatable if there are problems? Thank you very much!Doctor's answer:
Hello: Generally, municipal hospitals should be able to perform the examination.Antisperm antibodies are one of the most common causes of female infertility. Research has found that 15.18% of infertile women have antisperm antibodies present in their bodies. Under normal circumstances, both sperm and embryos are foreign to the mother. Therefore, each act of sexual intercourse can be considered an immunization, but only a small number of women develop antisperm antibodies. The reasons are as follows:
(1) Seminal plasma contains some immunosuppressive factors that can inhibit the function of T and B cells. These factors can be wrapped around the surface of sperm, preventing the female immune system from reacting to the sperm.
(2) Enzymes in seminal plasma can affect the expression of antigens on the sperm surface.
(3) After sperm enter the vagina, their surface is quickly covered by a layer of maternal proteins, which provides protection and helps the sperm move upward.
(4) Although millions of sperm are released during ejaculation, only less than 5% enter the uterine cavity. Since only sperm that enter the uterine cavity and abdominal cavity can sensitize lymphocytes, this significantly reduces the chance of women developing immunity. As a result, normal women rarely produce antisperm antibodies.
However, if any of the above links encounter problems, it may lead to women developing antisperm antibodies and subsequently becoming infertile. For example, sexual intercourse during menstruation or with conditions such as endometritis increases the chance of sperm and its antigens entering the bloodstream and coming into contact with immune active cells. If sperm enter the intestines (e.g., through the anus), the rectal mucosa is relatively thin and prone to injury. Additionally, the submucosal layer contains a higher number of Langerhans cells, which have functions similar to macrophages, making it easier for antigens to be transferred.