臨床婦人科産科65巻9号

2011年09月発行

今月の臨床 不妊診療のABC─ARTの前にできること 不妊原因診断とARTの前の対処法

10．免疫性不妊症

著者： 柴原浩章¹² 郡山純子¹² 池田伴衣¹² 平野由紀¹² 鈴木達也¹² 鈴木光明¹²

所属機関： ¹自治医科大学医学部産科婦人科学講座 ²自治医科大学附属病院生殖医学センター

ページ範囲：P.1156 - P.1165

　不妊症に悩むカップルが初めて病院を受診する理由の多くは，なぜ自分達は子供を授かれないのか，その原因を明らかにしたいという希望による．カップルが望む正確な原因診断を行ううえで，頻度が高い不妊症の三大原因である内分泌因子・卵管因子・男性因子の検査を進めるとともに，そのほかの原因検索の1つとして，頻度は少ないが免疫性不妊症の検査もできる限り早期に行う．

　このうち女性側の血中精子不動化抗体の検査法である精子不動化試験（SIT : sperm immobilization test）^1）は，検査センターに委託可能なことから一般化している．ところが同じ抗精子抗体の検査法でも，射出精子に結合する男性側の抗精子抗体の検出法である直接イムノビーズテスト（D-IBT : direct immunobead test）^2）は，新鮮精子を用いる検査であるため委託が難しく，自施設で行う必要があり，まだ十分には普及していない．しかしながら不妊女性の血中精子不動化抗体，あるいは不妊男性の射出精子上の精子結合抗体は，自験例でもおのおの約3％程度に検出できることから，同等に検査を行う意義はあるものと考える．

参考文献

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