The immunologic factor

[bannikovasm]

At inspection in occasion of sterility or barrenness assay kurtsroka-????NOa has appeared is negative, analyses on antibodies in a blood and a semen are negative, pipes are passed or taken place;passable, hormones in norm or rate, infections are not present. The doctor speaks, that antibodies are in slime. It is appointed or nominated gondonoterapiju within 6 months. How much such method of treatment is effective? What ways of disposal of antibodies are? Thanks.

[Anna Smirnova]

In such situations the endometrial insemination is much more effective.

[bannikovasm]

It is published: Anna Smirnova

In such situations the endometrial insemination is much more effective.



Thanks for the answer. But the doctor approves or confirms, what is it result will not give, as antibodies in slime are and in a uterus.

[boris]

Uv. bannikovasm!



The medical diagnosis biological incompatibility of spouses does not exist. At a household level this term is used often. An occasion for such conclusion, apparently, became cases when after disintegration of a fruitless married couple, in new family the former husband or the wife have children. Sterility or barrenness is an illness or a disease (the diagnosis is included into classification of illnesses or diseases). Therefore, when spouses speak are practically healthy , it only means, that the reason of sterility or barrenness is not found. However, the problem of sterility or barrenness very complex or difficult and modern classification of the reasons of sterility or barrenness of the World organization of public health services includes (CART) inexplicable (idiopathic, without the visible reasons) sterility or barrenness and unstated sterility or barrenness (the reason accessible methods of diagnostics to establish or install did not possible) which on ignorance can are carried to biological nesovmestivosti though them and are not.

Two reasons, really, can be carried to "biological" incompatibility. The first is an immunologic sterility or barrenness, i.e. sterility or barrenness connected with disturbances in immune system. The immune system provides protection of an organism against harmful influences. Disturbance of function immunoj systems can be shown that spermatozoons are perceived by an organism of the woman as the harmful agent .

It is possible to consider or count as other such reason the cervical (cervical) factor. For statement of the diagnosis of the sterility or barrenness caused by the cervical factor, in 1895 Russian scientist N.K.Shuvarsky has suggested to use biological assay of influence vulval or vaginal vydeleny on a semen. Later this assay (as it usually happens) has been modified foreign Gunterom and to this day wears their names. The short consists in the following: in 1-2 hours after the sexual relations under a microscope the material received from a vagina is investigated or researched. If in a preparation under greater or big augmentation mobile spermatozoons (5 and more) assay is considered positive are found out and it is necessary to search for the reason further. If mobile spermatozoons do not find, assay can be regarded as negative and one of the reasons - fatal influence of vulval or vaginal contents on spermatozoons. Certainly, these conclusions are correct, if before statement of this assay in the received ejaculate (a semen collected by a masturbation) there was enough of normal spermatozoons. However in a vagina and under normal conditions perishes about 30 % of spermatozoons and only the most hardy reach or achieve the cervical (cervical) channel to put to the following on trial - to influence of cervical slime. For an estimation of this stage of movement of a spermatozoon to the treasured purpose (to an ootid) in medicine assay kurtsroka-????NOa (both of the foreigner, have thought up assay in 1928) is used. Cervical slime place under a microscope together with an ejaculate of the husband. Since both substances are in a colloid status in artificial conditions they are insoluble in each other and come into contact only in a zone of contact. In norm or rate in 20-30 minutes spermatozoons in the form of separate wedges get into a drop of slime and continue the movement. If penetration does not occur or happen, it is possible to speak about the so-called cervical factor of sterility or barrenness.

Researches of last decade have revealed still a lot of the factors causing incompatibility of a married couple. All these factors have been incorporated in group of immunologic sterility or barrenness. The leaging role here belongs antispermalnym to antibodies.

The question on a role antispermalnyh antibodies (AsAT) in sterility or barrenness and genesial losses is discussed in the literature from the beginning of 80th years. In physiological conditions the AsAT are not formed, first of all owing to existence supressornyh (overwhelming their activity) mechanisms both in a semen, and in a genesial tract of the woman.

In disturbance physiological supressii antigens of a semen can result or bring inflammatory diseases of a female sexual tract, as clinically shown, and with asymptomatic current. It is shown, that at women with sexly-transmissible illnesses or diseases (illnesses or diseases passed sexual by) frequency of revealing the AsAT above, than at healthy women. antispermalnye antibodies can be found out in women in all departments of genesial system from a vagina up to a follicular liquid and in a blood. Thus it is noted, that presence circulating in a blood the AsAT not always is connected with presence of antibodies in a genesial tract.

Their damaging or injuring effects are diverse and can be divided or undressed on two groups:

The Effects immediately influencing process of a fertilization, consist in suppression of migration of spermatozoons through the cervical channel (it or this and the cervical factor speaks), disturbance of progress-progressive of spermatozoons and their destruction in a genesial tract of the woman, blocking of an attachment and penetration of a spermatozoon into an ootid, etc.

The Effects rendering negative influence already after a fertilization of an ootid by a spermatozoon: disturbance of crushing and normal development of embryoses (germ), direct negative action on viability of a developing embryos.

Different methods are applied to neutralization the AsAT. One of them is intravenous introduction gammaglobulina which last years is widely used abroad for correction of various autoimmune statuses. However high cost of this method limits its or his use at us in the country.

In the alternative and accessible way of treatment is immunotsitoterapija allogenic leucocytes. During the last 20- years immunotsitoterapija it is successfully used for prophylaxis and treatment of habitual spontaneous abortions.

Qualitative inspection can be provided in the specialized centers what are, in particular, the centers of planning of family and a reproduction which are in the majority of regions of Russia.

It is necessary to emphasize also, that all kinds of "biological" incompatibility including inexplicable sterility or barrenness, can be overcome by means of modern auxiliary genesial technologies, in particular by means of an extracorporal fertilization (EKO).



Therefore in your case it is possible to speak about the cervical factor (if other reasons are not present) and an optimum method, as well as has told or said Dr. Smirnova, there will be javljatsja an artificial insemination.

[bannikovasm]

Thanks for such detailed answer. But I still had one more question: whether means it, what the appointed or nominated treatment gondonoterapiej in struggle against antibodies will not give effect? And whether there are antibodies in a uterus? How it to define or determine?

[boris]

Uv. bannikovasm!



Whether means it, what the appointed or nominated treatment gondonoterapiej in struggle against antibodies will not give effect?

Sexual life with use of condoms as the accompanying component to set forth above me to methods of treatment can will be applied.



Whether there are antibodies in a uterus? How it to define or determine?

To spend the test for presence the AsAT in cervical slime.

[Jola]

Dear Boris!



Tell or Say, whether occurrence of the cervical factor if in marriage or spoilage already there is a child (and two pregnancies ended med.abortom) is possible or probable. At me secondary sterility or barrenness (1 year). Spermogramma the husband in norm or rate, at me a cycle constant - 28 days, hormones in norm or rate, monitoring of a follicle has shown - the ovulation occurs or happens, did or made GSG - pipes are passed or taken place;passable, the doctor is assured or confident, that that's all right. Has decided to do or make in this cycle laporoskopiju. And yesterday have made the postcoital test - and he negative. What to do or make?





Yours faithfully, Jola.

[boris]

To repeat the test.