Correlation between antisperm antibodies and hormonal profile in women with unexplained infertility

Hormonal–immune cross-talks are critical in the pathogenesis of unexplained infertility, where subtle endocrine alterations could be responsible for the development of antisperm antibodies (ASA). The aim of this case–control study was to evaluate the association of serum ASA with reproductive hormonal profile (Thyroid-stimulating hormone, Follicle-stimulating hormone, luteinizing hormone and prolactin) in women with unexplained infertility. In total, 120 women (20–38 years of age) were recruited for the unexplained infertility group (n = 66) and fertile control group (n = 54). Free fasting blood samples were obtained in the mid-cycle phase for levels of serum ASA and reproductive hormones–thyroid-stimulating hormone (TSH), prolactin, follicle-stimulating hormone (FSH) and luteinizing hormone (LH)—by standardized ELISA methods.Serum levels of ASA were significantly higher in women with unexplained infertility compared to the control group (p < 0.001). Hormonal profile showed a significantly raised mean prolactin level in infertile as compared to fertile women (p = 0.001), which was associated with significant rise of FSH (p = 0.004) and LH (p = 0.02); TSH did not revealed any statistical difference between two groups (p = 0.16). Correlation analysis demonstrated that ASA levels correlated significantly with prolactin (r = 0.42, p=0.001) and LH (r = 0.32, p=0.01), whereas the associations with TSH and FSH remained weak and non-significant. In addition, concentrations of ASA were significantly higher in women with infertility ≥5 years than <5 years (p = 0.04), suggesting a duration-related development of immune sensitization.These results indicate that increased ASA in patients with unexplained infertility might be due to some particular endocrine changes, especially hyperprolactinemia and enhanced LH activity. The present study demonstrates the value of combined immunological and hormonal assessment for diagnostic evaluation of unexplained infertility; it also emphasizes the necessity for additional investigation into immuno-endocrine mechanisms involved in reproductive failure.