Antisperm Antibodies

Defining Sperm Allergies

Some women fear they may have this condition due to painful intercourse or burning and itching after intimacy. In truth, symptoms like burning, itching, or inflammation signal other medical problems such as a genital tract infection.

"The condition known as 'sperm allergy' is not really an allergy; it does not make you sneeze," says Dr. Steven Witkin, a professor in the department of obstetrics and gynecology at Weill Medical College of Cornell University. "The immune system of some men and women see sperm as a foreign invader, like a germ, and their bodies make antibodies to attack the sperm." Antisperm antibodies may cause infertility by preventing the sperm from reaching and fertilizing the egg.

Indeed, infertility in one or both partners is the only symptom of antisperm antibodies. Infertility is generally diagnosed after a couple has tried to conceive for more than one year.

"I was terrified when I first heard the words 'sperm allergy,'" says Tammy Cole. "I very clearly remember looking at the slide under the microscope with the doctor and seeing tons of sperm—but nothing moving. I knew that could not be good news."

"Antisperm antibodies may be a complicating factor in as much as 5 to 10 percent of infertility cases," says Dr. Witkin. He adds that almost all men who have undergone a vasectomy (surgical operation that causes sterility) produce antisperm antibodies after the procedure. If he undergoes a vasectomy reversal, the antisperm antibodies will interfere with conception.

The Causes

So what sorts of things cause the immune system to make antisperm antibodies? A genital tract infection, a congenital abnormality in the male genital tract, a vasectomy (as mentioned above), or a varicocoele (a varicose vein in the testicles) can cause these antibodies to develop. Wives of men with abnormal sperm are also at increased risk for developing antisperm antibodies.

Testing for Allergies

When a couple experiences unexplained infertility, their doctor may recommend testing for antisperm antibodies. For males, a semen analysis can detect motionless or clumped sperm and identify the need for additional testing. Females undergo a post-coital test, in which a fluid sample is obtained from the cervix six to 12 hours after intercourse. The sample is then analyzed for the presence of shaking sperm. "In some cases, however, these tests may be normal, and antisperm antibodies may still be present," says Dr. Witkin.

A definitive diagnosis is reached after a couple undergoes a sperm antibody test. Dr. Witkin recommends the immunobead binding test (IBT) or the Mixed Agglutination Reaction (MAR) test. The IBT assesses the presence of antisperm antibodies in semen, cervical mucus, or the blood of either person. The MAR is performed on a semen sample. "There are other tests available but they are non-specific and inaccurate," he says. "In my office we perform the immunobead binding test."

"[My husband and I] were both saddened that we could not get pregnant without any medical intervention, but at the same time, happy that we were getting answers to why conceiving was taking so long," says Cole. "Before knowing too much about what [the diagnosis] meant, I immediately thought I could not have children. I was scared and frightened as well as determined to find out all the information I could. The doctor assured me there were ways around this 'allergy.'"