Reproductive immunology

Reproductive immunology refers to a field of medicine that studies interactions (or the absence of them) between the immune system and components related to the reproductive system, such as maternal immune tolerance towards the fetus, or immunological interactions across the blood-testis barrier. The concept has been used by fertility clinics to explain the fertility problems, recurrent miscarriages and pregnancy complications observed when this state of immunological tolerance is not successfully achieved. Immunological therapy is the new up and coming method for treating many cases of previously "unexplained infertility" or recurrent miscarriage.

The fact that the embryo's tissue is half foreign and unlike mismatched organ transplant, it is not normally rejected, suggests that the immunological system of the mother plays an important role in pregnancy. The placenta also plays an important part in protecting the embryo for the immune attack from the mother's system. Studies also propose that proteins in semen may help woman’s immune system prepare for conception and pregnancy. For example, there is substantial evidence for exposure to partner's semen as prevention for pre-eclampsia, largely due to the absorption of several immune modulating factors present in seminal fluid, such as transforming growth factor beta (TGFβ).

The presence of anti-sperm antibodies in infertile men was first reported in 1954 by Rumke and Wilson. It has been noticed that the number of cases of sperm autoimmunity is higher in the infertile population leading to the idea that autoimmunity could be a cause of infertility.Anti sperm antigen has been described as three immunoglobulin isotopes (IgG, IgA, IgM) each of which targets different part of the spermatozoa. If more than 10% of the sperm are bound to anti-sperm antibodies (ASA), then infertility is suspected. The blood-testis barrier separates the immune system and the developing spermatozoa. The tight junction between the Sertoli cells form the blood-testis barrier but it is usually breached by physiological leakage. Not all sperms are protected by the barrier because spermatogonia and early spermatocytes are located below the junction. They are protected by other means like immunologic tolerance and immunomodulation.

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