Iris Publishers- Open access Journal of Urology & Nephrology | Plasmapheresis in the Treatment of Male Infertility.
Literature Review and Own Observation
Authored by Valerii A Voinov
The problem of infertility is one of the most urgent problems of obstetrics and urology. Its frequency is in 5-11% of marriages, and, in addition to “female” there is and male infertility sometimes. Among its reasons play an important role autoimmune disorders when, after often have long forgotten injuries, and even orhiepididymitis varicocele arise autoantibodies against their own sperm that found in 8-21% of cases in men for suspected male infertility. They are capable of breaking the mobility of spermatozoa, and the ability of the latter to penetrate through the shell of the oocyte, without which it is impossible to even in vitro fertilization, the success of which in such cases does not exceed 40% [1].
In addition to autoantibodies, the functional state of sperm can be influenced by other toxic compounds of both exo- and endogenous origin, in particular, the generation of excessive amounts of cytotoxic oxidants [2-4]. In such cases, the sperm cells lose the genes for the oxidative phosphorylation [5]. In this case, the content of antispermal autoantibodies in the blood can increase to 3000-4000 units/ml (normally 75 units/ml) and up to 500-2000 units/ml in the ejaculate (at the same rate) [6]. The functional activity of spermatozoa is influenced by pollutants [7]. It was described the appearance of antisperm autoantibodies in men with detected virus (HSV, CMV) infections (31.1%) or with their biocenosis of bacteria (61.4 %) [8].
In systemic lupus erythematosus, the spermatogenesis with the appearance of antispermal autoantibodies is also disturbed and the treatment is carried out with the help of cyclophosphamide [9].
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