Seminal plasma hypersensitivity reactions: an updated review

Area of Science:

• Allergy and Immunology
• Reproductive Health
• Dermatology

Background:

• Seminal plasma hypersensitivity (SPH) involves allergic reactions to proteins in semen.
• It can cause various systemic and localized symptoms.
• Prevalence is unknown, potentially affecting 40,000 US women, with a link to atopy in systemic cases.

Purpose of the Study:

• To review the clinical presentation, diagnosis, and management of seminal plasma hypersensitivity.
• To highlight the role of prostate-specific antigen as a potential allergen.
• To discuss treatment options and their efficacy.

Main Methods:

• Diagnosis is primarily based on clinical history.
• Positive allergy tests include prick skin tests and serum-specific immunoglobulin E to seminal fluid.
• The gold standard for diagnosis is symptom prevention with condom use.

Main Results:

• Prostate-specific antigen is a suspected major allergen, though other proteins are implicated.
• 40-50% of cases can occur after first-time intercourse.
• Effective treatments include condoms, intravaginal graded challenges, and subcutaneous desensitization.

Conclusions:

• SPH is manageable with various treatment strategies, often leading to successful outcomes.
• While not directly causing infertility, SPH can impede conception due to the need for protected intercourse.
• Further research into prevalence and definitive risk factors is warranted.