臨床婦人科産科72巻11号

2018年11月発行

今月の臨床 男性不妊アップデート─ARTをする前に知っておきたい基礎知識

診断法

抗精子抗体

著者： 脇本裕¹ 杉山由希子¹ 柴原浩章¹

所属機関： ¹兵庫医科大学産科婦人科学講座

ページ範囲：P.1068 - P.1075

文献概要

●抗精子抗体は，女性では同種抗体として，男性では自己抗体として産生され，免疫性不妊症の一因となる．

●抗精子抗体の検出法として，女性側では精子不動化試験（sperm immobilization test : SIT）が，男性側ではイムノビーズテスト（immunobead test : IBT）が用いられている．

●WHOは精液検査の際に，運動精子上に結合する抗精子抗体の検出を推奨している．

参考文献

1）脇本　裕，他 : 精液検査/抗精子抗体．産婦人科外来パーフェクトガイド．pp125─130，医学書院，2018

2）宮本敏伸，他 : 男性不妊．臨婦産69 : 448─453, 2015

3）柴原浩章，他 : 産婦人科外来における精液検査．産婦治療102 : 669─676, 2011

4）Rumke P : The presence of sperm antibodies in the serum of two patients with oligozoospermia. Vax Sang 4 : 135─140 : 1954

5）Shibahara H, et al : Diversity of antisperm antibodies bound to sperm surface in male immunological infertility. Am J Reprod Immunol 47 : 146─150, 2002

6）Franklin RR, et al : Antispermatozoal antibody and unexplained infertility. Am J Obstet Gynecol 89 : 6─9, 1964

7）Isojima S, et al : Immunological analysis of sperm-immobilizing factor found in sera of women with unexplained infertility. Am J Obstet Gynecol 101 : 677─683, 1968

8）Koyama K, et al : Application of the quantitative sprm immobilization test for follow-up study of perm immobilizing antibody in the sera of sterile women. Int J Fertil 33 : 201─206, 1988

9）香山浩二 : 精子免疫．新編精子学（森沢正昭，他 編）．pp399─411，東京大学出版会，2006

10）Johnson L, et al : Further quantification of human spermatogenesis : germ cell loss during post prophase of meiosis and its relationship to daily sperm production. Biol Repros 29 : 207─213, 1983

11）Maddocks S, et al : Recent evidence for immune privilege in the testis. J Reprod Immunol 18 : 9─18, 1990

12）Baker HW, et al : Increased frequency of autoantibodies in men with sperm antibodies. Fertil Steril 43 : 438─441, 1985

13）Bronson R, et al : ability of antibody-bound human sperm to penetrate zona-freee hamster ova in vitro．Fertil Steril 36 : 778─783, 1981

14）Centola GM, et al : Comparison of the immunobead binding test（IBT） and immunospheres（IS） assay for detecting serum antisperm antibodies. Am J Reprod Immunol 37 : 300─303, 1997

15）Shibahara H, et al : Effects of sperm-immobilizing antibodies bound to the surface of ejaculated human spermatozoa on sperm motility in immunologically infertile men. Fertil Steril 79 : 641─642, 2003

16）Shibahara H, et al : Diversity of the inhibitory effects of fertilization by antisperm antibodies bound to the surface of ejaculated human sperm. Hum Reprod 18 : 1469─1473 : 2003

17）Shibahara H, et al : Diagnosis and treatment of immunologically infertile males with antisperm antibodies. Reprod Med Biol 4 : 133─141, 2005

18）Burkman LJ, et al : The hemizona assay（HZA） : development of a diagnostic test for the binding of human spermatozoa to the human hemizona pellucida to predict fertilization potential. Fertil Steril 49 : 688─697, 1988

19）World Health Organization : Laboratory manual for the examination and processing of human semen, 5th edition. Cambridge University Press, New York, 2010

20）Koriyama J, et al : Toward standardization of the cut-off value for the direct immunobead test using the postcoital test in immunologically infertile males.Reprod Med Biol 12 : 21─25, 2013

21）De Almedia M, et al : In vitro processing of sperm with autoantibodies and in-vitro fertilization results. Hum Reprod 4 : 49─53, 1989

22）Hjort T, et al : Autoantibodies to sperm, sperm motility and fertility prognosis. In Iojima S, et al（eds） ; Reproductive Immunology. pp197─206, Elsevier Science Publishers BV, Amsterdam, 1983

23）Parslow JM, et al : The clinical relevance of classes of immunoglobulins on spermatozoa from clinical relevance of classes of immunoglobulins on spermatozoa from infertile and vasovasostomized males. Fertil Steril 43 : 621─627, 1985

24）Bronson RA, et al : Sperm-specific isoantibodies and autoantibodies inhibit the binding of human sperm to the human zona pellucid. Fertil Steril 38 : 724─729, 1982

25）Mandelbaum SL, et al : Relationship of antisperm antibodies to oocyte fertilization in invitro fertilization-embryo transfer. Fertil Steril 47 : 644─651, 1987

26）Witkin SS, et al : Relation between antisperm antibodies and the rate of fertilizatrization of human oocytes in vitro. J Assist Reprod Genet 9 : 9─13, 1992

27）Dimitrov DG, et al : Correlation of asthenozoospermia with increased antisperm cell-medicated immunity in men from infertile couples. J Reprod Immunol 27 : 3─12, 1994

28）Nagy ZP, et al : Results of 55 intracytoplasmic sperm injection cycles in the treatment of male-immunological infertility. Hum Reprod 10 : 1775─1780, 1995

29）Esteves SC, et al : Influenceof antisperm antibodies in the semen on intracytoplasmic sperm injection outcome. Clin Urol 33 : 795─802, 2007