Clinical features:
(1) The patient usually has a history of atopy.
(2) The patient develops itching and swelling of perineal skin and vaginal mucosa, starting within minutes to hours after sexual intercourse
(3) Variable systemic symptoms (urticaria, rash, edema of hands, rhinitis, periorbital edema, conjunctivitis, asthma, cough, dyspnea, anaphylaxis) may develop.
Laboratory features:
(1) prick test using seminal fluid positive
(2) RAST positive
Prevention:
(1) Use of a condom.
(2) Use of antihistamines before or after exposure.
(3) Desensitization to seminal fluid (see below).
Pregnancy can be achieved by either:
(1) desensitization (see below)
(2) artificial insemination following removal of seminal proteins from the semen sample
Desensitization protocol of Matloff (performed with all precautions in a fully equipped medical facility):
(1) Dilute fresh semen sample using a diluent composed of phosphate buffered saline with human serum albumin (0.03 g/dL) and other additives.
(2) Instill 2 mL of a 1:1000 dilution into the vagina.
(3) 20 minutes later instill 2 mL of 1:100 dilution.
(4) 20 minutes later instill 2 mL of 1:10 dilution.
(5) 20 minutes later instill undiluted semen.
(6) This is followed by unprotected intercourse (while still at the medical facility).
(7) Desensitization is maintained by unprotected sexual intercourse at least twice a week.
