SS  Vol.2 No.1 , January 2011
Local Cell Mediated Immune Reaction in Primary Obstructive Male Infertility
Abstract
Increased intra-epididymal pressure due to obstruction causes a breach in the epididymal lining exposing the highly antigenic sperms to the interstitium. When the exposure is small and intermittent, it is likely to induce a local humoral response which may affect sperm maturation and also react with the epididymal epithelium producing irreversible histological changes. The present study on 30 patients of primary obstructive infertility found direct and indirect evidence of the production of antisperm antibodies locally. ELISA for antisperm antibodies was positive in the epididymal fluid in 16/30 (53%) of the patients. Indirect evidence of the role of local antigen-antibody reaction in the epididymis is apparent in 22/30 (73%) patients who had a lymphocytic infiltrate. The local presence of antisperm antibodies in the epididymal fluid correlated well with the presence of lymphocytic infiltration in the interstitium (p < 0.05). In our study 16/30 patients had a positive ELISA for antisperm antibody and all these patients had interstitial lymphocytic infiltration. In addition eight patients with a negative ELISA also showed interstitial lymphocytic infiltration. Thus 22/30 (73%) patients had an evidence of a local immune reaction directly in the form of a positive ELISA for antisperm antibodies in the epididymal fluid and / or indirect evidence in the form of lymphocytic infiltrate in the interstitium. None of the five controls had either a positive ELISA or lymphocytic infiltrate, this difference was found to be statistically significant (p < 0.005).

Cite this paper
nullA. Sarda, S. Bhalla, D. Pandey and S. Jain, "Local Cell Mediated Immune Reaction in Primary Obstructive Male Infertility," Surgical Science, Vol. 2 No. 1, 2011, pp. 31-37. doi: 10.4236/ss.2011.21008.
References

[1]   F. Francavilla, R. Romano, R. Santucci, G. L. Verghetta, P. D’Abrizio and S. Francavilla, “Naturally-Occurring Antisperm Antibodies in Men: Interference with Fertility and Implications for Treatment,” Frontiers in Bioscience Vol. 4, 1999, e9-25. doi:10.2741/Franca http://www.bioscience.org/1999/v4/e/franca/fulltext.htm

[2]   J. A. Collins, E. A. Burrows, J. Yeo and E. V. YoungLai, “Frequency and Predictive Value of Antisperm Antibodies among Infertile Couples,” Human Reproduction, Vol. 8, No. 4, 1993, pp. 592-598.

[3]   D. M. de Kretser, C. Huidobro, G. J. Southwick, and P. D. Temple-Smith, “The Role of Epididymis in Human Infertility,” Journal of Reproduction and Fertility, Vol. 53, Sup. 53, 1988, pp. 271-275.

[4]   M. A. Isahakia, “Characterization of Baboon Testicular Antigens Using Monoclonal Antisperm Antibodies,” Biology of Reproduction, Vol. 39, No. 4, 1988, pp. 889-899. doi:10.1095/biolreprod39.4.889

[5]   M. Dym, “The Fine Structure of the Monkey (Macaca) Sertoli Cell and Its Role in Maintaining the Blood-Testis Barrier,” Anatomical Record, Vol. 175, No. 4, 1973, pp. 639-656. doi:10.1002/ar.1091750402

[6]   N. J. Alexander & D. J. Anderson, “Vasectomy. Consequences of Autoimmunity to Sperm Antigen,” Fertility and Sterility, Vol. 32, No. 3, 1979, pp. 253-260.

[7]   M. G. Munoz and S. S. Witkin, “Autoimmunity to Spermatozoa, Asymptomatic Chlamydia Trachomatis Genital tract Infection and Gamma Delta T Lymphocytes in Seminal Fluid from the Male Partners of Couples with Unexplained Infertility,” Human Reproduction, Vol. 10, No. 5, 1995, pp. 1070-1074.

[8]   L. Linnet, T. Hjort and P. Fogh-Andersen, “Association between Failure to Impregnate after Vasovasostomy and Sperm Agglutinins in Semen,” Lancet, Vol. 1, No. 8212, 17, 1981, pp. 117-119.

[9]   J. M. Parslow, T. A. Poulton, G. M. Besser and W. F. Hendry, “The Clinical Relevance of Classes of Immunoglobulins on Spermatozoa from Infertile and Vasovasostomised males,” Fertility and Sterility, Vol. 43, No. 4, 1985, pp. 621-627.

[10]   H. Meinertz, L. Linnet, P. Fogh-Andersen and T. Hjort, “Antisperm Antibodies and Fertility after Vasovasostomy: A Follow-up Study of 216 Men,” Fertility and Sterility, Vol. 54, No. 2, 1990, pp. 315-321.

[11]   B. Ayvaliotis, R. Bronson, D. Rosenfeld and G. Cooper, “Conception Rates in Couples Where Autoimmunity to Sperms is Detected,” Fertility and Sterility, Vol. 43, No. 5, 1985, pp. 739-742.

[12]   P. J. Turek, “Infections Immunology and Male Infertility,” Infertility and Reproductive Medicine Clinics of North America, Vol. 10, No. 3, 1999, pp. 435-470.

[13]   A. M. Phadke, “Fate of Spermatozoa in Cases of Obstructive Azoospermia and after Ligation of Vas Deferens in Man,” Journal of Reproduction and Fertility, Vol. 7, No. 1, 1964, pp. 1-12. doi:10.1530/jrf.0.0070001

[14]   A. K. Sarda, S. A. Bhalla, N. Sarda, P. C. Pal and S. Salhan, “Effect of Primary Obstructive Infertility on Sperm Morphology”. The Internet Journal of Urology. Vol. 4, No. 2, 2007. http://www.ispub.com/ostia/index.php?xmlFilePath=journals/iju/vol4n2/sperm.xml

[15]   A. C. Chandley, N. MacLean, P. Edmond, J. Fletcher and G. S. Watson, “Cytogenetics and Infertility in Man II. Testicular Histology and Meiosis,” Annals of Human Genetics, Vol. 40, No. 2, 1976, pp. 165-176. doi:10.1111/j.1469-1809.1976.tb00176.x

[16]   S. J. Silber & L. J. Rodriguez-Rigau, “Quantitative Analysis of Testicle Biopsy. Determination of Partial Obstruction and Prediction of Sperm Count after Surgery for Obstruction,” Fertility and Sterility, Vol. 36, No. 4, 1981, pp. 480-485.

[17]   M. I. el-Demiry, T. B. Hargreave, A. Busuttil, K. James, A. W. Ritchie and G. D. Chisholm, “Lymphocyte Sub-popu- lations in the Male Genital Tract,” British Journal of Urology, Vol. 57, No. 6, 1985, pp. 769-774. doi:10.1111/j.1464-410X.1985.tb07051.x

[18]   M. Rajalakshmi, B. V. Kumar, M. M. Kapur and P. C. Pal, “Ultrastructural Changes in the Efferent Duct and Epididymis of Men with Obstructive Infertility,” Anatomical Record, Vol. 237, No. 2, 1993, pp. 199-207. doi:10.1002/ar.1092370207

[19]   E. M. McConnell, “The Histopathology of the Epididymis in a Group of Cases of Azoospermia with Normal Testicular Function,” British Journal of Urology, Vol. 53, No. 2, 1981, pp. 173-178. doi:10.1111/j.1464-410X.1981.tb03161.x

[20]   T. B. Hargreave, A. Busuttil, R. A. Elton, J. Harvey, A. Chan and G. D. Chisholm, “Studies of Testicular and Epididymal Damage in Relation to the Occurrence of Antisperm Antibodies,” British Journal of Urology, Vol. 54, No. 6, December 1982, pp. 769-773. doi:10.1111/j.1464-410X.1982.tb13645.x

[21]   F. Lombardo, L. Gandini, F. Dondero and A. Lenzi, “Immunology and Immunopathology of the Male Genital Tract. Antisperm Immunity in Natural and Assisted Reproduction,” Human Reproduction Update, Vol. 7, No. 5, 2001, pp. 450-456. doi:10.1093/humupd/7.5.450

 
 
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