Effects of paternal lymphocyte immunization in women with unexplained infertility.

OBJECTIVE: Infertility in women could be a result of an excessive production of antisperm antibody (ASA). Paternal lymphocyte immunization (PLI) could decrease the ASA levels, but the mechanism is still unclear. The aim of this study was to analyse the impact of a PLI-induced ASA decline on regulatory T-cell populations and serum interleukin-10 (IL-10) levels in women with unexplained infertility.

METHODS: Samples were obtained from patients who came to Sayyidah Mother and Child Hospital in Jakarta from July 2018 to April 2019 with infertility problems. The inclusion criterion for this study was unexplained infertility. Each patient was examined for ASA titres using husband's sperm auto-agglutination test (HSAaT) method, and patients with ASA titres >1:128 were given PLI subcutaneously every 3 weeks. ASA titres were evaluated again 2 weeks after PLI with HSAaT. A total of 12 samples were analysed. Regulatory T-cell populations were evaluated using flow cytometry and human forkhead box P3 FoxP3 staining kit of Biotech and Device, and serum IL-10 was determined using an Abcam ELISA kit. The data were analysed using Wilcoxon and Spearman tests.

RESULTS: PLI decreased serum ASA and percentage of regulatory T cells (p = 0.023). The decrease in ASA and subsequent decrease in regulatory T cell population was due to the strong negative correlation between regulatory T cells and IL-10 (r = -0.817, p = 0.004).

CONCLUSIONS: The decline in ASA was associated with a decrease in regulatory T cells due to a negative correlation with IL-10levels.