SPERM ANTIBODY AS FACTOR OF INFERTILITY IN NIGERIAN MALES

Abstract

Sperm antibodies (SA) have been observed as a cause of infertility. The production of the SA have in some circumstances been attributed to chronic infection of the genital tract. In Nigeria, sexually transmitted diseases (STDs) and infection related infertility are reportedly highly prevalent. The minimal studies that have been conducted in the male population would suggest that 40% of clinical infertility is male factor dependent. This study was therefore designed to define the role of SA in male infertility as well as determine the involvement of STDs in the production of such SA among Nigerians. Hypothetically, STDs may lead to the damage of the blood-testis barrier resulting in the exposure of sperm antigens to the immune system with the subsequent formation of sperm antibodies. This may be associated with reduced fertility in the long term. In this study, 182 adult males aged 18-56 years were investigated 85 were normospermic with no evidence of STDs and served as controls, 50 were infertile while 47 had proven STDs. Demographical characteristics were obtained through the administration of questionnaires. Anthropometric measurements such as height and weight were also obtained and body mass index was calculated from these indices. Biophysical analysis of semen was performed according to WHO guidelines while seminal zinc was analysed using atomic absorption spectrophotometer. These were carried out in order to ascertain the fertility status of the males. Fertility was confirmed using endocrinological measurements such as luteinizing hormone, follicle stimulating hormone, prolactin and testosterone. These were estimated by a double antibody radiommunoassay technique. Direct microscopy culture, and serology were performed on urine, semen, urethral swab and plasma in order to detect the presence or absence of STDs. Chlamydia IgG antibody and antigen were detected in plasma and urethral swab samples respectively using enzyme linked immunosobent assay (ELISA) kits since this set of organisms have been specifically associated with the production of sperm antibodies. Sperm antibodies-IgG, IgA and IgM were detected in plasma, seminal plasma and on spermatozoa using the currently used inimunobead binding technique. Appropriate statistical tests were carried out to indicate which variables are associated with SA. Result in this study showed that SA- IgG, IgA and lgM are present in plasma and semen. However, percentage binding of these SA on motile spermatozoa to immunobeads is low and comparisons of these SA in plasma and semen between infertile/STDs group and fertile control were not significantly different (p>0.05). The spermatozoan tail was observed as the most predominant region of binding of these SA in plasma and semen. Chlamydial IgG antibody was significantly associated with past history of STDs but was found significantly higher in fertile controls than both infertile and STDs groups (p<0.05). Gonococcal urethritis and non-specific urethritis were the most common infections in the STDs group. Biophysical parameters like sperm count, percentage motility and morphology were significantly lower in infertile than control (p<0.001). However, only percentage motility was significantly lower in STDs group than fertile controls (p<0.05) of all the seminal indices tested. Zinc and leukocytospermia were not significantly different between between infertile men, men with STDs and fertiie controls (p>0.05). Reproductive hormones- FSH, LH, prolactin and testosterone were also not significantly different (p>0 05) in comparisons between infertile and fertile groups. Similar observations were made between STDs and fertile groups except in prolactin which was significantly lower in STDs than fertile group (p<0.05). Results suggest that sperm antibodies are present but may not be associated with STDs or infertility in Nigerian males. Thus sperm count, percentage motility and percentage morphology are still the important indices in the assessment of male fertility status.