G'day Researchers,
Recently my boyfriend and I decided to try and conceive a child. 
After a number of attempts she kept noticing that I was having a dull
aching sensation, accompanied by a vague feeling of itchiness in the
region.  After doing some research we found that she likely has what
is known as "Human seminal plasma hypersensitivity", put simply a
semen allergy.

This has raised some pretty drastic concerns for us about my overall
ability to get pregnant.

I have already found a number of sites on the subject, which I have
listed below in the hopes that it'll give you a place to start your
research.  I plan on seeing a doctor soon, but at the moment I am in
the middle of moving to another part of the country and figured it'd
be best to see my new doctor about this.  It'll be a few weeks before
I can do that though and this is ever present on my mind, so I am
trying to get as much info as possible in the meantime.  What I would
like to know though is...

First, how will this impact my overall fertility?  I am willing to
work through the aching afterwards if it'll still be possible for get
pregnant.  But is that even possible through regular intercourse if I
am having an allergic reaction at the same time?  I saw something on
everything2.com that said there was no correlation between this and
fertility but I couldn't find another site which said that and I am
dubious of sites like wikipeida or everything2 for reliable
information.

Second, is there a risk of escalation due to further exposure?  The
aching is an annoyance at the moment but if we continue to try will
the reaction get more severe?  If it does worsen the allergy, would
that make it less likely that the allergy shots will work?

I guess the root of what I am asking is...if we try just during
targeted times, i.e. during ovulation which i think lasts like 4 days
a month, will this be worthwhile? Is my ability to conceive impaired
or is the reaction just unpleasant for me (and possibly risky if
things progress).

Thank you very much for your help.  I understand that this isn't a
substitute for actual medical advise, I just need these questions (and
whatever else you can find of interest about
treatment/symptoms/diagnosis, etc which isn't on the pages i link to
below) answered so I can know.  Please don't sugar coat the answer for
me, nothing is worse then false hope.

Thanks again!!

P.s. generous tip for a really good answer!

Everything2
http://everything2.com/index.pl?node_id=1361620
Swedish Medical Center
http://www.swedish.org/17099.cfm

Prevalence of human seminal plasma hypersensitivity among symptomatic women
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=9012622&dopt=Abstract

Women's Health
www.womenshealth.org%2Fa%2Fsemen_allergy.htm

Cool Nurse 
http://coolnurse.healthology.com/focus_article.asp?f=sexual_health&b=coolnurse&c=xml_semenallergy

Hi brownblanket-ga, and thanks for your question.  Sorry to hear of
your unfortunate condition!  I think I can give you some more reliable
information.  As usual, the following isn't a substitute for medical
advice or direct medical evaluation and treatment.


Seminal plasma protein hypersensitivity is a known, although rare, 
medical entity.  On research article focuses on reproduction in the
context of this disorder:

Resnick DJ. Hatzis DC. Kanganis P. Liccardi FL. Lee-Wong M. Bernstein
JA. The approach to conception for women with seminal plasma protein
hypersensitivity. [Case Reports. Clinical Trial. Journal Article]
American Journal of Reproductive Immunology. 52(1):42-4, 2004 Jul.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=15214941&query_hl=8&itool=pubmed_docsum

You can request a free reprint from Dr. Resnick at New York Presbyterian Hospital:
djr115@juno.com


The authors describe the condition:

"Human seminal plasma protein hypersensitivity (SPH), although rare,
is more common than previously recognized.[1] It was first reported by
a Dutch gynecologist J.L.H. Specken in 1958.[2] Immunologic responses
to seminal fluid antigens in women may result in local and or systemic
reactions.[3] Symptoms may consist of diffuse urticaria, stridor,
wheezing, vulvovaginal pain or burning, nausea, vomiting and facial,
tongue, lip and or laryngeal edema. These reactions typically occur
within 30 min post-coitus. Although the etiology is not clearly
defined, researchers believe that most reactions are IgE-mediated
against glycoprotein antigens in seminal plasma.[4,5] These
glycoproteins are Human seminal plasma protein hypersensitivity (SPH),
although rare, is more common than previously
recognized.[1] It was first reported by a Dutch gynecologist J.L.H.
Specken in 1958.[2] Immunologic responses to seminal fluid antigens in
women may result in local and or systemic reactions.[3] Symptoms may
consist of diffuse urticaria, stridor, wheezing, vulvovaginal pain or
burning, nausea, vomiting and facial, tongue, lip and or laryngeal
edema. These reactions typically occur within 30 min post-coitus.
Although the etiology is not clearly defined, researchers believe that
most reactions are IgE-mediated against glycoprotein antigens in
seminal plasma.[4,5] These glycoproteins are mainly produced in the
prostate gland and are present in all males. With most allergic
conditions, avoidance is the treatment of choice. Abstinence or condom
usage will prevent symptoms of SPH.

This approach, however, is unacceptable to many couples especially
when the woman wants to conceive. Local subcutaneous injections with
human seminal plasma proteins (SPP) has been successful and considered
the gold standard for desensitizing patients with localized and/or
systemic SPH; however, several case reports suggest that intravaginal
graded challenge with whole seminal plasma may also be effective.[5?9]
Many women who desire unprotected intercourse in order to conceive are
unable to afford the expense of systemic desensitization and do not
respond to treatment with seminal plasma intravaginal graded
challenge. Therefore, alternative approaches to induce conception are
necessary when treatment of this disorder is ineffective or not able
to be implemented. We report a 25-year-old woman who failed whole
seminal plasma intravaginal graded challenge but successfully
conceived through in vitro fertilization."


The point of the article is that SPH is not associated with
infertility.  One common approach is to attempt to desensitize the
woman to the antigens in the semen by "intravaginal graded challenge."
 There are other approaches, and an allergist would likely be the best
person to approach for more guidance.

One of the concerns is that someone such as yourself with this type of
hypersensitivity could be at risk for a life threatening anaphylactic
reaction.  I would again recommend evaluation by an allergist to
determine the proper method of desensitization, if appropriate.  An
Ob/Gyn would be the appropriate person to advise you on fertility, but
they are unlikely to be well equipped to deal with the allergic
component of your condition.

The National Guidelines Clearinghouse has this to say:

"Seminal Fluid-Induced Anaphylaxis

38. Anaphylaxis caused by human seminal fluid has been shown to be due
to IgE-mediated sensitization by proteins of varying molecular
weights. (B)
39. Localized seminal plasma hypersensitivity has been well described
and is likely IgE mediated on the basis of successful response to
rapid seminal plasma desensitization. (C)
40. History of atopic disease is the most consistent risk factor.
However, anecdotal case reports have been associated with gynecologic
surgery, injection of anti-RH immunoglobulin, and the postpartum
state. (C)
41. The diagnosis is confirmed by means of skin and/or in vitro tests
for serum-specific IgE by using proper reagents obtained from
fractionation of seminal fluid components. (C)
42. Prevention of reactions to seminal fluid can be accomplished by
barrier use of condoms. (C)
43. Immunotherapy to properly fractionated seminal fluid proteins has
been universally successful in preventing anaphylaxis to seminal
fluid, provided the sensitizing seminal fluid fractions are used as
immunogens. Successful intravaginal graded challenge with
unfractionated seminal fluid has been reported in a few cases, but the
duration of protection is unknown. (C)
44. Localized and/or systemic seminal plasma hypersensitivity is not
associated with infertility. (D)"

http://www.guideline.gov/summary/summary.aspx?ss=15&doc_id=6887&nbr=4211

______________________

I hope this information is useful.  I've included some additional
references at the bottom for further reading.  Please feel free to
request any clarification prior to rating.  Best wishes in your quest
for parenthood!  It's one of the most rewarding experiences life has
to offer.

Best,

      -welte-ga


====================================================

Here's a Bibliography of medical research articles that discuss SPH. 
You can find their abstracts, and in some cases the full text, by
typing the "UI" number into PubMed:
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi

Here's an example (screenshot) for the 1st reference:
http://img32.imageshack.us/img32/5837/pubmedexample3rb.jpg

If there's an article you're interested in that isn't freely available
online, you can always e-mail the "contact" author, who is usually
listed in the Abstract, and request a free reprint.  These can usually
be e-mailed as PDF files, although I have received faxes and Air Mail
from Japan in the past.  Authors are usually more than happy to send
out copies of their work to anyone who's interested.

__________


1. Weidinger S. Ring J. Kohn FM. IgE-mediated allergy against human
seminal plasma. [Review] [45 refs] [Journal Article. Review] Chemical
Immunology & Allergy. 88:128-38, 2005.
UI: 16129942


2. Resnick DJ. Hatzis DC. Kanganis P. Liccardi FL. Lee-Wong M.
Bernstein JA. The approach to conception for women with seminal plasma
protein hypersensitivity. [Case Reports. Clinical Trial. Journal
Article] American Journal of Reproductive Immunology. 52(1):42-4, 2004
Jul.
UI: 15214941

3. Shah A. Panjabi C. Human seminal plasma allergy: a review of a rare
phenomenon. [Review] [77 refs] [Journal Article. Review] Clinical &
Experimental Allergy. 34(6):827-38, 2004 Jun.
UI: 15196267

4. Babula O. Bongiovanni AM. Ledger WJ. Witkin SS. Immunoglobulin E
antibodies to seminal fluid in women with vulvar vestibulitis
syndrome: relation to onset and timing of symptoms. [Journal Article]
American Journal of Obstetrics & Gynecology. 190(3):663-7, 2004 Mar.
UI: 15041996

5. Shah A. Panjabi C. Singh AB. Asthma caused by human seminal plasma
allergy. [Journal Article] Journal of Asthma. 40(2):125-9, 2003 Apr.
UI: 12765313

6. Prandini M. Marchesi S. Allergy to human seminal fluid: a case of
self-diagnosis. [Case Reports. Journal Article] Allergy. 54(5):530,
1999 May.
UI: 10380792

7. Drouet M. Sabbah A. Hassoun S. Thirteen cases of allergy to human
seminal plasma. [Case Reports. Journal Article] Allergy. 52(1):112-4,
1997 Jan.
UI: 9062641

8. Bernstein JA. Sugumaran R. Bernstein DI. Bernstein IL. Prevalence
of human seminal plasma hypersensitivity among symptomatic women.
[Journal Article] Annals of Allergy, Asthma, & Immunology. 78(1):54-8,
1997 Jan.
UI: 9012622

9. Yocum MW. Jones RT. Yunginger JW. Concurrent sensitization to
natural rubber latex and human seminal fluid. [Letter] Journal of
Allergy & Clinical Immunology. 98(6 Pt 1):1135-6, 1996 Dec.
UI: 8977523

10. De Cuyper C. Bogaerts Y. Vandekerckhove F. Gunst J. Intravaginal
desensitization and successful pregnancy in a woman with seminal fluid
allergy. [Case Reports. Journal Article] Journal of Allergy & Clinical
Immunology. 97(6):1427-8, 1996 Jun.
UI: 8648047

11. Babarinsa IA. Ajayi AB. Adeleye JA. Coitally--related morbidities
in the non-pregnant female. [Review] [63 refs] [Journal Article.
Review] West African Journal of Medicine. 14(3):141-6, 1995 Jul-Sep.
UI: 8519700

12. Bernstein JA. Herd ZA. Bernstein DI. Korbee L. Bernstein IL.
Evaluation and treatment of localized vaginal immunoglobulin
E-mediated hypersensitivity to human seminal plasma. [Case Reports.
Journal Article] Obstetrics & Gynecology. 82(4 Pt 2 Suppl):667-73,
1993 Oct.
UI: 8378007

13. Matloff SM. Local intravaginal desensitization to seminal fluid.
[Case Reports. Journal Article] Journal of Allergy & Clinical
Immunology. 91(6):1230-1, 1993 Jun.
UI: 8509583

14. Jones WR. Allergy to coitus. [Review] [48 refs] [Journal Article.
Review] Australian & New Zealand Journal of Obstetrics & Gynaecology.
31(2):137-41, 1991 May.
UI: 1681800

15. Boppana SB. German DF. Frick OL. Chronic vulvovaginitis in a
30-year-old woman. [Case Reports. Clinical Conference. Journal
Article] Annals of Allergy. 66(5):381-4, 1991 May.
UI: 2035900

16. Presti ME. Druce HM. Hypersensitivity reactions to human seminal
plasma. [Review] [38 refs] [Journal Article. Review] Annals of
Allergy. 63(6 Pt 1):477-81, 1989 Dec.
UI: 2688490

17. Shah A. Sethi S. Agarwal MK. Human seminal plasma allergy in
India. [Case Reports. Journal Article] Journal of Asthma.
25(3):137-40, 1988.
UI: 3182586

18. Best CL. Walters C. Adelman DC. Fixed cutaneous eruptions to
seminal-plasma challenge: a case report. [Case Reports. Journal
Article] Fertility & Sterility. 50(3):532-4, 1988 Sep.
UI: 3410107

19. Wasson AW. Coy EA. Kooistra JB. Yunginger JW. Seminal plasma
immunosuppressive factors in the spouse of a woman with seminal fluid
allergy. [Journal Article] American Journal of Reproductive
Immunology. 15(3):99-100, 1987 Nov.
UI: 3434662

20. Sell MB. Sensitization to thioridazine through sexual intercourse.
[Case Reports. Letter] American Journal of Psychiatry. 142(2):271-2,
1985 Feb.
UI: 3970259

21. Frisch C. Pujade-Lauraine MD. Leynadier F. Dry J. Rush
hyposensitisation for allergy to seminal plasma. [Case Reports.
Journal Article] Lancet. 1(8385):1073-4, 1984 May 12.
UI: 6143999

22. Shapiro SS. Kooistra JB. Schwartz D. Yunginger JW. Haning RV Jr.
Induction of pregnancy in a woman with seminal plasma allergy. [Case
Reports. Journal Article] Fertility & Sterility. 36(3):405-7, 1981
Sep.
UI: 7286261

23. Kooistra JB. Yunginger JW. Santrach PJ. Clark JW. In vitro studies
of human seminal plasma allergy. [Case Reports. Journal Article]
Journal of Allergy & Clinical Immunology. 66(2):148-54, 1980 Aug.
UI: 7400478

24. Skandhan KP. Evaluation of infertility due to semen antigenicity
and certain techniques adapted for its detection. [Review] [110 refs]
[Journal Article. Review] Panminerva Medica. 21(4):191-6, 1979
Oct-Dec.
UI: 122117

25. Jones WR. Gale AE. Concerning seminal plasma allergy. [Case
Reports. Letter] Annals of Allergy. 41(5):325, 1978 Nov.
UI: 717855

26. Voorhorst R. Female allergy to seminal fluid. [Case Reports.
Letter] Annals of Allergy. 41(4):252, 1978 Oct.
UI: 568439

27. Reunala T. Koskimies AI. Bjorksten F. Janne J. Lassus A.
Immunoglobulin e-mediated severe allergy to human seminal plasma.
[Case Reports. Journal Article] Fertility & Sterility. 28(8):832-5,
1977 Aug.
UI: 885272

28. Chang TW. Familial allergic seminal vulvovaginitis. [Journal
Article] American Journal of Obstetrics & Gynecology. 126(4):442-4,
1976 Oct 15.
UI: 984106

29. Berger H. Allergy to human semen. [Journal Article] New York State
Journal of Medicine. 75(7):1072-3, 1975 Jun.
UI: 1056537

30. Siraganian RP. Schenkein I. Levine BB. Immunologic studies of a
patient with seminal plasma allergy. [Journal Article] Clinical
Immunology & Immunopathology. 4(1):59-66, 1975 May.
UI: 47797

31. Mikkelsen EJ. Henderson LL. Leiferman KM. Gleich GJ. Allergy to
human seminal fluid. [Journal Article] Annals of Allergy.
34(4):239-43, 1975 Apr.
UI: 1124861

32. Schulz KH. Schirren C. Kueppers F. Letter: Allergy to seminal
fluid. [Journal Article] New England Journal of Medicine. 290(16):916,
1974 Apr 18.
UI: 4816982

33. Kolodny RC. Koehler BC. Toro G. Masters WH. Sperm-agglutinating
antibodies and infertility. [Journal Article] Obstetrics & Gynecology.
38(4):576-82, 1971 Oct.
UI: 5110038