Today, a fairly large number of couples face the problem of infertility. In almost half the cases, the cause is the male factor. However, at present, thanks to modern methods of diagnosis, treatment and reproduction, such couples can have their own child.
Spouses are usually advised to start testing after a year of trying to get pregnant. However, today this period is sometimes extended to two years. On the other hand, now doctors strongly recommend that they be examined already at the planning stage of the baby. This avoids unpleasant surprises during pregnancy, reduces the risk of developing various pathologies.
Examination of a man necessarily involves the delivery of a spermogram. This analysis allows us to judge not only about its fertility, but also the presence of problems with the reproductive system.
One of the most important indicators in the study of ejaculate is sperm agglutination. This is the phenomenon of their bonding to each other in different parts. In normal sperm, sperm agglutination should be completely absent. Since it not only reduces their mobility, but also interferes with normal fertilization.
The spermogram must indicate the degree of agglutination using the number of pluses:
- “+” - single groups with no more than 5 adherent spermatozoa;
- “++” - single groups, but in them from 10 to 20 cells;
- “+++” - the total number of groups is more than 5, each containing several tens of spermatozoa;
- "++++" - adherent cells predominate in the field of view.
Moderate sperm agglutination can occur in fertile, healthy men. However, if its rate is high, then this may indicate an immunological factor of infertility, as well as chronic inflammation or autoimmune processes in the body.
False agglutination is also distinguished. This phenomenon of sperm adhesion is not among themselves, but with lumps of mucus, destroyed cells, macrophages, epithelium.
In addition, agglutination must be distinguished from another indicator of spermogram - aggregation. This is the presence of sites of accumulation of sperm. Aggregation reduces their mobility and may indicate violations and diseases in the body of a man.
If sperm agglutination is detected, then it is necessary to be examined for infections to exclude inflammation. Especially if the number of leukocytes and red blood cells in the spermogram is increased.
However, most often sperm agglutination, the treatment of which depends on its cause, is a consequence of the production of antisperm antibodies (ASAT) by the male immune system. In order to confirm this assumption, it is necessary to make a spermogram with the MAR test.
The aim of this study is to identify ASAT in the ejaculate of a man. They damage the membrane of the spermatozoa, sticking together with them.
If the cause of agglutination is antisperm antibodies, treatment should be carried out only if it impedes conception. They do not deliver any other inconvenience to a man. If agglutination is a consequence of inflammation, then it must be treated. With the help of additional analyzes, it is necessary to establish the pathogen and conduct the necessary therapy.
In any case, deviations in the spermogram are an occasion to visit a urologist or andrologist. In addition, before making any conclusions, it is necessary to draw it several times, observing all the rules for the delivery of ejaculate.
Sometimes, with minor deviations, it is enough to normalize nutrition, the regime of work and rest, give up alcohol and tobacco, and drink vitamin complexes. Vitamins E, C, folic acid, as well as fructose and zinc are very important for male fertility.
If conservative treatment does not give the desired result, then you can always resort to reproductive technologies. Artificial insemination, IVF, ICSI have proven themselves in the fight against male infertility.
Thus, sperm agglutination is a deviation from the norm, however, if it is slightly expressed, then pregnancy can occur naturally. The treatment of this pathology depends on its cause, but most often it is ASAT. Therapy should be prescribed only by a qualified specialist. With its failure, you can use reproductive technology.