Patient's question:
Doctor: Hello! I previously had antisperm antibodies, which later turned negative and I got pregnant, but the pregnancy stopped at three months. Now I am preparing to get pregnant again, but I haven't been able to conceive for six months. I have mild-moderate cervical erosion and have had antisperm antibodies before. 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 should be taken? If there are problems, can they be treated? 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 could be considered an immunization, but only a few 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 sperm.
(2) Enzymes in seminal plasma can affect the expression of antigens on the surface of sperm.
(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, fewer than 5% of them enter the uterine cavity. Only sperm that enter the uterine cavity and abdominal cavity can sensitize lymphocytes. This significantly reduces the chance of women developing immunity, so normal women rarely produce antisperm antibodies.
However, if any of the above steps encounter problems, it may lead to women developing antisperm antibodies and subsequently infertility. For example, sexual intercourse during menstruation or when suffering from conditions like endometritis increases the chances of sperm and its antigens entering the bloodstream and coming into contact with immune active cells. If sperm enter the intestines (such as the rectum), 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.