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The body's immune system is our first and major line of defense
against diseases and invading germs. It is comparable to soldiers
stationed at the borders of a country, always ready to defend
against any form of attack. The body's immune system has the
intelligence to differentiate between the normal body cells
and foreign/invading cells. It can trigger off a local or
widespread alarm response or attack against invading microbes.
It can also keep memories of these offending cells, so that
it can repel them if they ever show up next time. The body's
immune system works like a perfectly set up machine. However,
it does have its shortcomings. There may be times when, for
some reason, it breaks down and leaves the body at the mercy
of invading microbes. There could also be times when the ability
to differentiate between body cells and foreign cells goes
sour and the immune system will turn its arsenal of attack
against normal healthy body cells it is suppose to protect,
causing damage to the body system.
The immune system plays a vital role in normal body functioning
and the reproductive system is not excluded. Several cells
of the immune system help in the reproductive process. For
example, some inflammatory cells and their secretory products
are important in ovulation and in the preparation of the endometrium
of the uterus for the implantation of the fertilized egg.
It is therefore not surprising to learn that any dysfunction
of the immune system would interfere with the normal reproductive
process and by extension, fertility.
As a matter of fact, it is estimated that up to 20% of otherwise
'unexplained' infertility in couples have an immune factor
involved. There is not so much scientific evidence to link
immune factors to infertility; however, there is a solid scientific
evidence to implicate the formation of antibodies against
sperm cells as an important infertility factor.
Normally, the sperm cells are protected from the reach of
the immune system by tight connections between the cells lining
the male reproductive tract, a natural protective mechanism
known as the 'Blood Testes barrier'. This protects the testes
from having any contact whatsoever with the blood, where the
majority of immune cells are housed. Any injury or condition
that compromises this barrier gives the immune cells access
to the sperm cells. The immune system, not familiar with these
sperm cells, because of the barrier separating them, treats
the sperm cells as foreign cells and anti sperm antibodies
may be formed.
Anti sperm antibodies tend to be commoner in infertile men.
Almost 10% of all infertile men have anti sperm antibodies
compared to about 1% of fertile men.
The most profound risk factor happens to be surgery on the
reproductive tract. Nearly 70% of all men who have undergone
a vasectomy reversal would have anti sperm antibodies present
on their sperm. Other factors that may also contribute to
this condition include:
- Varicocele or dilation of the veins surrounding the spermatic
cord
- Testicular torsion or twisting of the testicle
- Undescended testes
- Cancer of the testes
- Infections like prostatitis
- Inguinal hernia surgical repair, especially before puberty.
It is amazing to note, however, that several men with anti
sperm antibodies have none of these conditions. This shows
that every man with fertility problems is at risk of this
condition, especially when no other reason has been diagnosed
for the infertility.
Women also stand a risk of anti sperm antibodies. It is
believed that about 5% of women with fertility problems could
have these antibodies. What is not clear is who is at risk
for their formation. Fortunately, intra uterine insemination,
which involved placing 'treated sperm cells' into the uterine
cavity of a woman, has not been shown to cause the formation
of anti sperm antibodies.
The immune system has also been found to affect the ability
to carry pregnancy in some women. In women with recurrent
pregnancy loss, there is a group of antibodies that appear
to attack an early developing pregnancy, resulting in either
a miscarriage or severe preeclampsia with risk of intrauterine
growth retardation or even foetal death. These antibodies
are collectively called anti phospholipid antibodies and testing
for them should be an integral part of the work up for recurrent
pregnancy loss. It is still unclear if these antibodies affect
the ability to get pregnant, but some physicians are of the
opinion that the presence of these antibodies may decrease
the chances for pregnancy through an invitro fertilization.
There are still several controversial areas as regards immunological
factors and infertility. However, what is clear is that the
immune system really does affect your fertility when things
go wrong.
About the Author
Michael Russell
Your Independent guide to Infertility
Fertility
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