Immunomodulatory Treatment of Infertility in Men with Elevated Antisperm Antibodies

Abstract

Possible causes of subfertility or infertility in men are still poorly defined, but one important category may be elevated level of antisperm antibodies (ASA) caused by infective and/or autoimmune diseases, as well as injuries of male reproductive system. In this study, blood sera from 45 infertile men of different age with ASA positive ELISA test were examined for the serum level of ASA before and after treatments with 1α,25-dihydroxy-Vitamin-D3 (Vitamin D3) and Dexamethasone. We observed 23 infertile men treated with Vitamin D3 + Dexamethasone during 30 days, 12 infertile men treated with Dexamethasone only during 30 days and 10 infertile men without any treatment. Before treatment all selected patients showed poor parameters of semen analysis and high level of ASA serum concentration (>75 U/ml). After treatment serum concentration of ASA in control group (321.8 U/ml) and Dexamethasone only treated group (287.7 U/ml) were significantly higher compared to Vitamin D3 + Dexamethasone treated group (120.2 U/ml). In addition, serum level of ASA in Vitamin D3 + Dexamethasone treated group was significant less as compared to the level before the treatment (P<0.01). The treatment by Vitamin D3 + Dexamethasone were accomplished by successful pregnancy in three cases (13%). These results can be explained by numerous immunomodulatory and immunosuppressive effects of Dexamethasone and Vitamin D3 regarding antibody production, co-stimulatory molecules expression, immune cells communications and development of specific cytokine network profile. Since the therapeutic approach is relatively new, this is the first study of Vitamin D3 and Dexamethasone treatment concerning the suppression of ASA production.