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대한생식의학회지 제19권 제2호 2010년
접합자 난관내 이식 환자에 있어서 수정 실패와 항정자 항체와의 관계 및 난자와 정자의 재처리에 관한 연구
차병원 여성의학연구소;차병원 여성의학연구소;차병원 여성의학연구소;차병원 여성의학연구소;차병원 여성의학연구소;차병원 여성의학연구소;
정미경;고정재;도병록;구정진;한세열;차광열;,
Study on the Detection of Anti-Sperm Antibodies in Zygote Intra Fallopian Transfer (ZIFT) Patients with Fertilization Failure or Low Fertilization Rate and Retreatment of Oocyte and Sperm
Chung, M.K.;Ko, J.J.;Do, B.R.;Koo, J.J.;Han, S.Y.;Cha, K.Y.;
Department of Obstetrics and Gynecology, Infertility Medical Center of Cha Women's Hospital;Department of Obstetrics and Gynecology, Infertility Medical Center of Cha Women's Hospital;Department of Obstetrics and Gynecology, Infertility Medical Center of Cha Women's Hospital;Department of Obstetrics and Gynecology, Infertility Medical Center of Cha Women's Hospital;Department of Obstetrics and Gynecology, Infertility Medical Center of Cha Women's Hospital;Department of Obstetrics and Gynecology, Infertility Medical Center of Cha Women's Hospital;
Previous studies have indicated that immunological factor is responsible for the infertility. We have detected sperm antibodies in ZIFT patients which grouped as fertilization failure (A; n=18) and low fertilization rate (${\leq}50%$)(B; n=20). Patients, however, had normal oocytes and sperms. We collected serum from wives and semen from husbands and donors (fertile sperm), if it was needed. We examined class, binding patterns and amounts of antisperm antibodies(ASA) by direct and indirect immunobead binding assay. In group A, 11 husbands were ASA positive showing 62.2% and 61.1% binding with IgA and IgG, respectively, and two wives were ASA positive showing 70.0% and 71.0% binding with IgA and IgG, respectively. Binding sites were mainly at the head of sperms (84%). In group B, 8 husbands were ASA positive showing 37.5% and 40.0% binding with IgA and IgG, respectively, and two wives were ASA positive showing 41.3% and 42.0% binding with IgA and IgG, respectively. Binding sites were also mainly at the head of sperms (78%). For the treatment of ZIFT patients who had fertilization failure at the first trial, we used albumin fractionation method and dilution method with 30% fetal cord serum (FCS) to reduce the titer of ASA. We used partial zona dissection (P.Z.D.) method for wives who have antisperm antibodies in their serum. According to represented method, we could inhance the fertilization rate to 60.0% by albumin fractionation and 20.0% by P.Z.D., respectively. We concluded that the use of micromanipulation like P.Z.D. or the other sperm processing methods is required to increase a chance of fertilization. This result suggested that it should be a prerequisite to test antisperm antibodies prior to entering assisted reproductive technologies (ART) programs.
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