90% antis-perm antibodiesAfter a vasectomy reversal, a semen analysis in our WHO accredited semen analysis suite at 3 months can provide much joy and excitement when a positive result is announced. Some couples never get to this stage as they have conceived before this time and do not attend for analysis. However, we have found that there is sufficient information online about the analysis results for some couples to stop focussing on their positive results and the associated good chance of being able to conceive and instead become fixated on the anti-sperm antibodies instead. Recently, it has come to our attention that some forums, where people have shared experiences and want to support others, have provided advice and have not helped as they have given the impression that they were knowledgeable and in fact, all they have done is created fear and negativity with their lack of knowledge.

Anti-sperm Antibodies – The Vasectomy Reversal Centre Experience

Fact 1: Many of the men have anti-sperm antibodies after their vasectomy reversal. These could have developed as a consequence of the vasectomy, previous trauma to the groin or just being a keen cyclist – all known causes of anti-sperm antibodies.

Fact 2: We have had many men with high levels of anti-sperm antibodies after vasectomy reversal where their partners have conceived a child. Science does not know the full mechanism by which these anti-sperm antibodies work (see below).

Fact 3: We have evidence that levels of anti-sperm antibodies do fluctuate. Again, we do not understand why or when this happens but we do know that if this does happen, then there is always a chance that conception and pregnancy can occur.

The Science of Anti-sperm Antibodies for Vasectomy Reversal Patients

We have looked through the available science to assist you and to reinforce our advice. A study [1] looked at the different levels of semen antibodies in 351 cycles of ICSI where the men had had their semen analysed for levels of antibodies. This group of men was compared to 349 cycles of ICSI where the men did not have their semen analysed due to the low numbers of sperm present. The result was that there was no difference in the outcomes of ICSI meaning that the different levels of anti-sperm antibodies did not affect the fertility of the sperm.

Our comment: Although none of the men had had vasectomy reversal surgery, it does support the fact that the level of anti-sperm antibodies post vasectomy reversal is not directly associated with infertility.

A review [2] of many studies investigating fertility and the presence of anti-sperm antibodies identified an absence of clear scientific data concerning anti-sperm antibodies. The review concluded that therapy for the majority of cases of sperm-bound anti-sperm antibodies’ associated infertility remains largely unknown and unproven. Another, later study [3] highlighted the fact that there was still so much not known about sperm antigens in relation to fertility and that further work was needed to help clarify the controversy and to establish the significance of ASA (anti-sperm antibodies) in infertility.

Our comment: So this means that there is still so little known which is why we have had pregnancies with high anti-sperm antibody levels: science, as yet, does not have all the answers.

An interesting review article [4] states, importantly, that there is wide variability of anti-sperm antibodies among individuals and this may be why the detection of anti-sperm antibodies has low predictive value for fertility and that its clinical significance in infertility is uncertain and does not influence the fertility prognosis. The authors explained that anti-sperm antibodies are different for each antigen and each of these have different effects on sperm function, some even having no effect on sperm function.

Our comment: So until the full function of the different types of anti-sperm antibodies are understood, it is not possible to definitely state that there is no hope if they are found at semen analysis. Subsequently, there is no definitive treatment whether it be a prescribed drug, an over the counter or on the internet product that has scientifically been proven.

Possible treatments

There is no research to support the use of steroids in anti-sperm antibodies vasectomy reversal patients. Steroids are known to reduce sperm production so would always be advised to be avoided. There is also no research to support the use of Zinc supplements in anti-serum antibodies vasectomy reversal patients. There is no research to support the use of any other online or over the counter supplement in the reduction of anti-sperm antibodies in men who have had a vasectomy reversal. There is scientific proof that frequent ejaculation of 2 -3 times a day reduces the amount of anti-sperm antibodies. Paradoxically, this would cause a reduction in sperm count as there would be insufficient time for the sperm to reproduced in the numbers required. We do advise that you eat well and follow the advice in our Pro-Sperm diet.

Our Advice

Unless you are speaking with a qualified urologist online, please do not assume that your online contact is fully knowledgeable of the facts. We find in the long term that this does more harm than good and causes needless anxiety.

References

1. Influence of anti-sperm antibodies in the semen on intracytoplasmic sperm injection outcome. Int. Braz J Urol. vol.33 no.6 Rio de Janeiro Nov./Dec. 2007

2. Anti-sperm antibodies: Do anti-sperm antibodies bound to spermatozoa alter normal reproductive function Hum. Reprod. (1999) 14 (10): 2426-2429. doi: 10.1093/humrep/14.10.2426

3. Modalities for treatment of anti-sperm antibody mediated infertility : novel perspectives Am J Reprod Immunol 2004 May;51(5):390-7

4. Anti-sperm Immunity and Infertility Expert Rev Clin Immunol. 2008;4(1):113-126