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'm preparing to get pregnant again, but haven't been able to conceive in six months. I have mild-moderate cervical erosion and have had antisperm antibodies before. I've 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 I should take? 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.Anti-sperm antibodies are one of the most common causes of female infertility. Research has found that 15.18% of infertile women have anti-sperm 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 small number of women develop anti-sperm 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 beed on 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. Since only sperm that enter the uterine cavity and abdominal cavity can sensitize lymphocytes, this significantly reduces the chance of women developing anti-sperm antibodies. As a result, normal women rarely produce anti-sperm antibodies.
However, if any of the above steps encounter problems, women may develop anti-sperm antibodies and subsequently become 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 easily damaged, and the submucosal layer contains a high number of Langerhans cells, which have functions similar to macrophages. This makes it easier for antigens to be transferred.