臨床婦人科産科69巻5号

2015年05月発行

今月の臨床 月経異常・不妊症の診断力を磨く

不妊症

5．免疫性不妊

著者： 柴原浩章¹² 児島輝仁¹² 鹿嶋見奈¹² 森本篤¹² 加藤徹¹² 長谷川昭子¹²

所属機関： ¹兵庫医科大学産科婦人科学講座 ²兵庫医科大学病院生殖医療センター

ページ範囲：P.438 - P.447

文献概要

●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，おのおの約3％程度に検出できる．抗精子抗体による不妊症の発生機序は，精子の運動障害作用と受精阻害作用である．

●血中に精子不動化抗体を保有する女性には，SI₅₀値が10未満の低抗体価の場合はAIHを，10以上の高抗体価の場合はIVF-ETを選択する．

●精子結合抗体を有する男性には，精子の受精障害を認める場合にはICSIを，受精障害を認めない場合，頸管粘液内通過障害を認める場合はAIHを，認めない場合はタイミング療法から，おのおの治療を開始する．

参考文献

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