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ASAb

Anti-sperm antibodies

Anti-sperm antibodies (ASAb) are a major cause of infertility and are found in 9-36% of infertile couples, and are caused by an immune response to sperm and they can affect one, or both partners. i ASASb tend to affect men more than women and it’s a lot easier for men to get checked for anti-sperm antibodies as part of a standard semen sample test.

Men usually have a barrier between their blood and their testes, which separates sperm from their immune system. When sperm come into contact with the immune system it’s possible an immune response will be triggered to these abnormal cells (they only contain half a normal cell’s DNA).

Once an immune response has developed the acquired immune system makes antibodies specific to sperm and these can be found in the mucous membranes of the urogenital tracts. The ASAb physically attach themselves to sperm, making it extremely difficult for them to reach or fertilise an egg:

  • Over 50% of men with low sperm motility carry ASAb. ii
  • About 66% of men with no live sperm carry ASAb. iii
  • Up to 70% of men who’ve had a vasectomy or a vasectomy reversal have ASAb. iv

For men who know their testes or the surrounding area has had trauma, an ASAb test is a definite consideration, especially when the couple is struggling to get pregnant. Women can also develop antibodies to sperm, and they can be found in blood and cervical mucus. There are a number of ways they can develop, but they won’t be specific to a single man’s sperm:

  • Women can develop anti-sperm antibodies from male partners who have them.
  • The chances of a woman having ASAb rises with male sexual partner numbers. v
  • About 7% of women with infertility, implantation failures and recurrent miscarriage have ASAb. vi
  • Natural conception is much harder for women with ASAb as many sperm are inactivated in the cervical mucus.
  • Women with ASAb are more likely to have antiphospholipid antibodies.

Tests

This is either with the woman’s blood or the man’s semen (or both). For men, the test involves the addition of a substance to the sample that only binds to ASAb affected sperm, and this gives the percentage of sperm with anti-sperm antibodies. The higher the ASAb level, the lower the chance of enough sperm reaching the egg.

Western medicine treatment

There is a range of options that range from suppressing the immune system with corticosteroids or cyclosporine or assisted reproductive techniques including IUI, IVF or ICSI.

Medicinal herbal treatments

There are several herbal combinations that are reportedly effective for ASAb, with success rates of around 86% (38 patients), vii which are only available from qualified practitioners.