PATHOGENESIS OF REDUCED FERTILITY IN AUTOIMMUNE REACTIONS AGAINST SPERM


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Abstract

Objective. To show a relationship between autoimmune reactions against spermatozoa, their functional characteristics, and real fertility. Subjects and methods. Clinical and laboratory examination was made in 425 men from infertile couples aged 18—45 years, the fertile men, the wives of whom were 8—16 weeks pregnant, formed a control group (n=82). Their sperm was examined in accordance with the WHO requirements; computer-aided sperm analysis was used. Antisperm antibodies (ASA) were determined in the sperm by MAR test and flow cytofluorometry and in the serum by ELISA. Spontaneous and ionophore A23187-induced acrosome reactions were examined by the double fluorescence sperm staining method using fluorescin isothiocyonate-labelled P. sativum lectin and tetramethyl rodamine isothiocyanate-labelled A. hypogaea lectin. Oxidative stress was assessed by luminol-dependent chemiluminescence assay. Chromosome damage was evaluated from DNA fragmentation by the chromatin dispersion test of sperm in inert agarose gel, with visual microscopic estimation of halo formation after acid denaturation of DNA and lysis of nuclear proteins. Results. The decline in real fertility is proportional to the percentage of MAR-positive spermatozoa. Autoimmune reactions against spermatozoa are accompanied by hyperproduction of reactive oxygen species. There is a positive correlation between MAR test results and track velocity of spermatozoa, amplitude of their head oscillation, percentage of spermatozoa with a premature or none acrosome reaction, and their proportion with DNA fragmentation and its degree. Conclusion. The leading factors reducing fertility in men with ASA are sperm dysfunction: premature hyperactivation, an increased and/or none acrosome reaction, and enhanced DNA fragmentation. The pathogenesis of pathospermia in immune infertility is associated with oxidative stress.

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About the authors

V. A BOZHEDOMOV

I.N. Sechenov First Moscow State Medical University; Peoples' Friendship University of Russia

M. A NIKOLAYEVA

Academician V.I. Kulakov Research Center of Obstetrics

Email: MNikolaeva@oparina4.ru

I. V USHAKOVA

Academician V.I. Kulakov Research Center of Obstetrics

Email: ir_ushakova@oparina4.ru

E. A SPORISH

Peoples' Friendship University of Russia

I. M ROKHLIKOV

Peoples' Friendship University of Russia

N. A LIPATOVA

Peoples' Friendship University of Russia

G. T SUKHIKH

I.N. Sechenov First Moscow State Medical University; Academician V.I. Kulakov Research Center of Obstetrics

Email: g_sukhikh@oparina4.ru

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