Association of anti-sperm antibodies with chronic prostatitis: A systematic review and meta-analysis

Highlights

• The literature searches of our article were comprehensive.

• Meta-analysis was performed to evaluate the correlation of ASA and chronic prostatitis.

• Our study illustrates that there have significant correlation between ASA and Chronic prostatitis.

• Our results might shed valuable insights into the relationship between chronic prostatitis and male reproduction.

Abstract

Chronic prostatitis is a risk factor for impaired male fertility potential, and anti-sperm antibodies (ASAs) cause the autoimmune disease immune infertility, which has a negative effect on semen parameters. Current studies have investigated the ASA-positive relationship between chronic prostatitis versus normal controls, but have shown inconsistent results. Hence, we systematic searched the PubMed, EMBASE, Science Direct/Elsevier, Medline, and the Cochrane Library up to October 2015 for case-control studies that involved the ASA-positive relationship between chronic prostatitis patients versus normal controls. The meta-analysis was performed with Review Manager and Stata software. After literature search, six studies were identified, including 721 cases of chronic prostatitis and 160 normal controls. Our results illustrated a significant correlation of the ASA-positive relationship between chronic prostatitis patients versus normal controls. The combined odds ratio of the ASA-positive rate in chronic prostatitis patients and normal controls was 3.26 (1.86–5.71). There was also a significant correlation of the ASA-positive relationship between National Institutes of Health (NIH) III versus normal controls, and the combined OR was 2.46 (1.10–5.51). However, there was no significant correlation of the ASA-positive relationship between National Institutes of Health (NIH) II versus normal controls. The present study illustrates that the positive rate of ASAs in chronic prostatitis patients was significantly higher than in the control group, suggesting that chronic prostatitis has a negative effect on male reproductive function. However, studies with larger samples are needed to better illuminate the correlation between ASAs and chronic prostatitis.

Introduction

Prostatitis is the most common urological disease in men under the age of 50 years, with prevalence ranging from 2.2% to 9.7% worldwide, with an overall rate of 8.2% (Krieger et al., 2008). It is defined as a heterogeneous mixture of syndromes, with broad diagnostic criteria but its etiology and pathophysiology are somewhat vague (Sharp et al., 2010, Pontari and Ruggieri, 2008). The prostate is a male accessory sex organ that provides secretions vital for normal fertility. It secretes several major components of seminal plasma that nourish and protect spermatozoa following ejaculation. The current study considered the prostate to be an immunocompetent and not an immunoprivileged site as previously thought (Whitmore and Gittes, 1977, Kramer et al., 2007). Given the intimate association of the prostate with male reproductive function, prostatitis has long been suspected of playing a role in male subfertility. But strong evidence for a direct impact of prostatitis on male fertility is lacking.

Research on anti-sperm antibodies (ASAs) began in 1899, when it was initially reported that sperm could be antigenic if injected into a foreign species (Landsteiner, 1899). The presence of ASAs in infertile men was first reported by Rumke (1954) and Wilson (1954). Since then, ASAs have been considered by several authors as a possible causative factor in infertility, with significant levels being detected in the semen of 5–15% (Adeghe, 1993) of infertile men but in only 1–2% (Ayvaliotis et al., 1985, Bates, 1997) of fertile men. It is assumed that the development of ASAs is mainly a consequence of trauma to the blood–testis barrier, epididymis, or vas deferens (Gubin et al., 1998). ASAs is also associated with inflammation, and their appearance is often thought to be of idiopathic origin (Lenzi et al., 1997).

Current studies have investigated the correlation between the presence of ASAs and chronic prostatitis, but have shown contradictory results. Some studies have shown a significant ASA-positive relationship in patients with chronic prostatitis compared with healthy individuals (Hoover and Naz, 2012, Marconi et al., 2009, Mie, 2009), but not other studies (Deng et al., 1992, Qin et al., 2005, Zhang et al., 2004). Therefore, we systematically reviewed the available literature and performed a meta-analysis to evaluate the correlation of ASAs and chronic prostatitis, which might shed valuable insights into the relationship between chronic prostatitis and male infertility.