What does a negative MAR test mean and how to interpret a positive result. MAP test (positive and negative): what it is, interpretation of results

Male infertility is just as common as female infertility. One of its types is immunological infertility. It occurs when sperm loses its motility because there are antibodies on its surface that form an anti-sperm coating around the gamete. To find out whether the presence of such antibodies is the cause of infertility in a man, you need to take a MAR test (IgA, MAR is usually deciphered as “mixed agglutination reaction” or “mixed antiglobulin reaction”).

Where do antisperm bodies come from?

Antibodies are proteins produced by the immune system that bind to foreign bodies in the body, such as viruses and bacteria. This is one of the ways in which the body protects itself and distinguishes “its” from “theirs”. Healthy body should not react aggressively to its own cells.

Gametes (sex cells; in men - sperm, in women - eggs) differ from other cells in the body in their structure, genetics and peculiar characteristics. This distinction can be dangerous because the body's defense system begins to view sperm as a hostile object that must be destroyed. This is why the seminiferous tubules healthy body in a man, they are separated from the blood vessels by a barrier of blood. This barrier can be damaged by certain diseases and injuries. After that reproductive system men begin to produce protective substances that are aggressive to sperm and sperm.

The amount of antibodies determines the scale male infertility.

How to identify and find these antibodies?

The doctor can assume that a man has antibodies to sperm not only according to the MAP test, but also according to the results of the spermogram. Sperm immobility is indirect evidence of immunological infertility. The MAP test must be performed in conjunction with a semen analysis, or the patient must have its results available no earlier than three months back.

If a man has suffered testicular trauma, has a hydrocele (hydrocele) or other diseases that cause antibody production, the doctor may also order a spermogram with a MAP test.

MAP test: how to take it for a man (preparation)

A man should avoid sexual intercourse, alcohol and excessive heat (bath or sauna) for 2-5 days before the test. Sperm is collected after masturbation in a container. In the laboratory, the researcher will mix it with a special antiserum. If the sperm contains antibodies, they will react with this serum to form an "antigen-antibody".

In addition, a doctor may order a man to have blood tested for antisperm cells if his semen sample contains too many immotile sperm. The MAP test is usually performed within 24 hours, urgent analysis can be ready after two hours.

MAR-TEST: DECODING

A few percent (from 0 to 9) – this result is considered normal.
A MAP test result of 10-30% means that the situation is not critical. Pregnancy is still possible because the remaining sperm are still ready to fertilize the egg.
If more than 40-50% of sperm are covered with antibodies, the MAR test result will be positive. This means that the man has immunological infertility. In this case, treatment is necessary.

Thus, the lower the percentage in the MAP test results, the fewer antibody-coated sperm in the sample, and the higher the chance of conception.

Decoding the MAP test in the table

WHAT DO MAR TEST RESULTS MEAN IN MEN?

The result is expressed as the percentage of sperm associated with antibodies (usually two subclasses of antibodies are recorded: IgG and IgA).

Anything less than 10% is considered a negative result. A negative MAP test means that a man has little or no antibodies in a sperm test that could prevent conception. In this case, the problem of infertility lies in something else.

A result of 10 to 39% may indicate immunological infertility. Antibodies have been detected, but conception is still possible since the remaining sperm remain active.

In the case of 40% or more, the diagnosis of immunological infertility is most likely, since this is the number of sperm that are associated with antibodies and cannot fertilize the egg. Essentially, these are useless active sperm. WHO currently considers 50% and above as a level that may negatively affect fertility.

TREATMENT FOR A POOR MAR TEST

If a man has a positive MAP test, steroids may be helpful because they can lower antibody levels and temporarily increase the chance of conception. However, in this case, serious side effects that such drugs have.

Intrauterine insemination is another treatment option that can be tried for immunological infertility. In this case, specially prepared sperm is injected into the woman's uterus.

In vitro fertilization (IVF) is a popular method that is also successfully used to overcome difficulties in conceiving in the presence of sperm antibodies.

If previously a woman was almost always blamed for infertility, it has now been proven that in 30-50% of cases men are to blame for the absence of children. Besides basic analyzes and spermograms, when studying male fertility, the Mar test is used. What does such an analysis mean, when a mar test is used, and how can you understand its results yourself?

Mar-test is a modern laboratory test sperm, which allows you to detect and determine the percentage of sperm covered with so-called (ASAT).

Antisperm is a type of protein body with a complex structure that attaches to the sperm and limits its speed and viability.

The mar test also determines the area of the sperm where antibodies are attached: on the head, neck or tail. The test also detects spermatozoa normal structure and mobility, but have lost the ability to fertilize.

If the Mar test shows positive results, it is recommended to confirm it by analyzing the patient’s blood serum for antisperm antibodies.

The difference between a mar test and a spermogram

The causes of male infertility can be difficult to diagnose. And if the “root of evil” lies in immunological problems, then a spermogram with such abnormalities can be absolutely normal. Only a mar test can detect antisperm antibodies, which are the main immunological cause of infertility, in the ejaculate. Immunological disorders lead to infertility in 10-20% of cases, and it is impossible to identify them by other research methods.

If sperm are coated with antisperm antibodies, they still remain motile, but cannot fertilize the egg.

The speed of sperm movement in this case is significantly reduced. The penetration of male germ cells into the egg is especially difficult if the antibodies are located on their head. One spermogram is not enough to obtain full picture sperm quality, since it determines only the quantitative composition of the ejaculate and sperm motility. Therefore, patients with infertility are also prescribed a Mar test.

Cause of autoimmune infertility

Why can the body resist pregnancy? It is well known that the immune system is designed to protect our body. She also actively participates in the process of conception.

Sex cells differ from ordinary cells in having half the number of chromosomes: sperm have only 23. Therefore, the body tends to consider sperm as foreign cells that need to be destroyed.

There are two types: immune and autoimmune.

For immune infertility female body reacts by producing antibodies to the partner’s sperm in its womb. This happens when the membrane of the female genital organs is damaged, when there is close contact of sperm with circulatory system genital area. The causes of this type of disorder are often trauma to the genital organs, erosion or inflammatory diseases among women.

With autoimmune infertility, the man’s body itself produces antibodies that damage its own sperm. Normally, sperm are surrounded by a barrier that prevents them from being recognized and damaged. However, for a number of reasons, this barrier is broken and antibodies are produced aimed at sperm. Such antibodies coat the sperm, which leads to their gluing and freezing. In this case, the male sex cells become unable to penetrate through the cervical fluid into the egg and provide successful conception. In studies, ACAT can be detected in both blood and semen. Similar failures are possible with infectious lesions of the male genital area, injuries, and cystic transformations.

When prescribing a mar-test, it is important to clarify which spouse the doctor suspects is producing antisperm antibodies and what are the reasons for this failure.

Indications and contraindications for the mar test

Usually the mar test is prescribed in situations for unknown reasons infertility with:

suspected male factor infertility;
planning pregnancy (if there is a suspicion of autoimmune infertility or infertility for an unknown reason);
sperm agglutination during spermogram;
after genital surgery;
reproductive research male system after aggravating factors (injuries, operations, infections);
preparation for assisted fertilization techniques (IVF, ).

Sometimes such research is impossible to carry out. The Mar test is contraindicated in the absence or low number of sperm in the ejaculate.

Carrying out a mar test in men

If a man plans to take a mar test, he will first have to make an appointment with an andrologist in one of reproductive clinics or centers.

Mar test can be:

direct (when seminal fluid is taken for research);
indirect (when blood plasma is examined).

The direct form of this test is more accurate.

Carrying out a mar test is as follows:

The sperm samples are mixed with other cells (red blood cells or latex particles) coated with human antibodies (HAT).
IgG antiserum is added to the mass of sperm and red blood cells (or latex particles).
Spermatozoa, coated with antibodies, stick together with the injected particles.
The glued spermatozoa are counted to determine the result as a percentage. The percentage of deformed sperm indicates the presence of immune infertility.

How is the Mar test performed in women?

The mar test is usually prescribed to men. However, the female body may also be to blame for autoimmune infertility. This study in women can also be of two types:

direct method - when the condition of the cervical mucus and the degree of sperm connection with it is assessed (often used after sexual intercourse -);
indirect method - when blood plasma is examined.

For women, two types of test are used:

In the form of the Shuvarsky-Sims-Hüner test. This analysis is performed within 12 hours after sexual intercourse (necessarily before ovulation). In this case, the mobility of sperm in the vaginal discharge is determined.
In the form of a Kurzrock-Miller test. This study is also carried out before ovulation. Wherein cervical mucus the woman is mixed with a man's sperm sample to evaluate the resulting substrate.

When is a mar test prescribed?

The most common causes of autoimmune infertility are:

genital injuries (including after surgery);
infections;
diseases of the pelvic organs.

Preparation

Most often, the mar test is performed with a spermogram on the same day, from the same sperm sample.

For reliable analysis, it is important to follow the following preparation rules:

For the mar test, ejaculate from masturbation is used. Sperm after sexual intercourse is not suitable for research.
If you take hormones later than six months before the test, the test results may be distorted.
10 days before the test, visiting the sauna or steam bath is excluded.
When treating genital inflammation, a Mar-test is not performed. And 7 days before the analysis, the use of any drugs or dietary supplements is excluded.
Avoid contact with toxic substances 2-3 days before the study (when working during harmful conditions, contact with chemicals, etc.).
Avoid the use of spicy and fatty foods.
It is necessary to abstain from sexual contact a week before collecting material. This is necessary to exclude the presence of cells of the female reproductive system.
Ensure rest and avoid any overexertion the day before the test.
Avoid alcohol for a week and smoking 3-4 hours before the test.
Organization good sleep one day before the analysis.
If a man has had ARVI or influenza, the test is not performed until he has fully recovered.
Before donating sperm, you must urinate and wash your genitals with soap. When masturbating, do not use lubricant or use a condom.
Particular attention is paid to the issue of collecting material for the test. The sperm is collected in a sterile container. It is important to deliver the material to the laboratory no later than an hour after its collection (especially when collecting analysis at home). Otherwise the result will be unreliable.
It is prohibited to overcool or overheat the sperm container. The optimal temperature for transporting seminal fluid is body temperature. In this case, do not allow direct sunlight to hit the container.
The answer from the analysis can be found out the next day after it is submitted. The reliability of the result is usually confirmed after 2 weeks in the form of a repeat study.

Transcript of the test

The mar test must be deciphered by a professional in the field reproductive health. When reading the transcript of this study, it is important to know that:

a negative result is a good test indicator;
positive result- the result is bad.

An important factor in deciphering the mar test is the indication of the site of ACAT attachment.

The attachment of antibodies to the head of the sperm is considered the most unfavorable.

If the test answer is negative, this means that the semen contains sufficient quantity full spermatozoa. And this is great, since this couple has a high chance of getting pregnant naturally.

How to understand a positive test result? This result indicates that the structure of more than half of the sperm is disturbed. All this indicates a high probability of immunological infertility.

The higher the percentage of the mar-test result, the more the result lags behind the norm, and the more less chance for paternity of the man under study.

How to understand mar test results

A mar test rate of less than 10% is considered the best. And the lower the number, the better. The main thing is that this study has a negative result with a value of less than 50%. This result suggests that less than half of the sperm in the analysis had an antisperm coating. This indicator is considered normal, since a man with a similar sperm characteristic has a normal chance of conceiving a baby. In the test, such a result is read as “mar test - normal.”

If more than 50% of sperm with antisperm antibodies are found in the semen, the test is considered positive. If even the sperm are motile, but more than 50% of them are covered with ASAT, then this answer is equivalent to high probability male infertility. Such a diagnosis is quite serious for a couple.

When ACAT is produced in the body, men speak of autoimmune infertility. If such antibodies are produced by the female body, then infertility is considered immune.

What to do if the result is positive

If the mar test gives a 100% result, this most likely indicates the couple’s inability to become pregnant naturally. However, there is no need to despair when receiving even such the most unfavorable research result. Thanks to modern technologies, pregnancy is quite possible in this case.

If the mar test result is positive, it is quite possible to use assisted reproductive techniques. For example, application in similar situations IVF or IVF+ICSI technicians allow you to get pregnant even with a 100% positive result.

Although such a study of sperm is still less known than a spermogram, it is the mar test that is able to identify the immunological causes of infertility. And don’t despair if this test is positive. In many cases, such a result is not a death sentence and can be corrected. And when modern capabilities assisted reproductive technologies, conception is possible even with a 100% positive mar-test.

If a woman cannot get pregnant within a year, but she is absolutely healthy, then the man will have to take a spermogram. The spermogram is medical research activity and motility of sperm in order to determine various diseases reproductive function, which affected sperm.
Many men wonder how to take a spermogram correctly so that the test results are accurate. Sperm is a very sensitive biological material. Therefore, before taking a spermogram, it is necessary to carry out proper preparation. Also, you need to take a spermogram only in specialized clinics, where specialists who know how to conduct analysis correctly work. The fact is that the analysis must be performed within an hour after the spermogram is taken.

How do you prepare for a spermogram?

Before taking a spermogram, a man must follow the following rules:

What errors can happen during sperm donation?

Everyone knows perfectly well how a spermogram is taken: through masturbation in medical clinic This process is carried out in a special room. You should not submit for analysis sperm that was obtained through sexual intercourse at home. During sexual intercourse, the first part of the sperm is lost, and, in addition, the acidic environment of the vagina can damage the sperm. If a man cannot donate sperm in a clinic, the conditions are uncomfortable for him, then donation at home is allowed. Cream, Vaseline or other lubricants that come in during masturbation can have a negative effect.

A special disposable plastic jar is used for testing. The volume of the jar is 50 ml. The use of a glass jar is possible only after thorough sterilization. The lid of the jar must be removed before ejaculation. To prevent dirt or other negative microorganisms from getting into the container, do not handle it inner side. For bacteriological examination (sperm culture), only a sterile container should be used.

Within an hour, the sperm must be delivered to the laboratory at body temperature. If it is being transported, temperature changes must be excluded. The sample jar is marked with the man's initials. If the biological material was not collected in full quantity, then this should be reported to the doctor at the appointment.

Detailed spermogram and mar test

The price of a spermogram depends entirely on the amount of information a man wants to know. When submitting a detailed spermogram to Invitro, it becomes possible to find out more information about the activity and motility of sperm. The detailed spermogram includes such indicators as:

standard semen analysis according to WHO;
mar test;
strict adherence to Kruger morphology.

Statistics show that 10-20% of men suffer from infertility due to exposure to an immune factor. In the formation of immune infertility main role play autoantibodies to their own sperm. Violation of defense activity at any stage can result from the formation of antisperm antibodies. It is these antibodies that contribute to a decrease in sperm activity and motility.

To detect an immune factor interfering with fertilization, the mar test is used. It determines the amount of antisperm antibodies in semen. Biological material is combined with sperm and latex particles or red blood cells, which, in turn, are coated with human antibodies from the IgA or IgG group. IgG serum is then added.

There are contraindications to taking the mar test. After appropriate treatment has been carried out to get rid of these pathologies, you can take the mar test. Contraindications:

when a small number of active sperm was detected in the spermogram;
in the presence of cryptozoospermia and azoospermia.

Where can I get a spermogram and what analysis indicators are examined?

During analysis it turns Special attention on such properties of sperm as:

Liquefaction.
Quantity.
Viscosity.
Hue.
Alkaline environment.
Leukocytes and erythrocytes.

A spermogram in Moscow can be taken at any specialized clinics where there is separate rooms to carry out deposition biological material in special containers. Also make sure that the clinic employs a competent specialist who knows how to properly analyze spermograms. The main indicators of a spermogram are the number of active and motile sperm. Normally, it is considered that a healthy man has at least 15 million active and motile sperm in 1 ml of semen. If this is not observed, then the man is diagnosed with oligozoospermia, that is, a decrease in the level of sperm activity.

Currently, more and more couples are faced with the difficulty of conceiving a baby. Not always like this intimate problem associated with a woman. It also happens that a man experiences difficulty conceiving.

For diagnostics reproductive pathologies which can lead to the impossibility of natural conception, specific studies are required. One of them is the mar test.

What it is?

To assess male fertility (ability to fertilize), several types of studies are required. They are prescribed by an andrologist or urologist after an extensive clinical examination of the man.

During this routine diagnostic procedure the doctor identifies external signsvarious pathologies genitals. If during the examination the doctor suspects some kind of disease, then he will prescribe laboratory tests for the man.

Spermogram and MAR test are the most common and frequently prescribed types of examinations. In most cases, only the first research method is sufficient.

Using this analysis, the doctor can determine how mobile and active male reproductive cells are, as well as determine the number of leukocytes in the ejaculate. This examination helps the specialist obtain overview information about the state of men's health.

However, in some cases this may not be enough. In this situation, the doctor will prescribe man MAR-test. In fact this study is immunological. It is necessary to determine whether an immune factor is present in the development of infertility.

The abbreviation of the test gives us an idea of the essence of the study. The full name of this study in English is Mix antiglobulin reaction. Russian-speaking specialists call it a mixed antiglobulin reaction.

The essence of the study is define percentage in the sperm of spermocytes associated with immunoglobulins of classes A and G (igA, igG), and also determine antisperm antibodies.

There are 2 options for this study. The most commonly used method is the direct method. In this case, the percentage of male germ cells is determined, which is associated with immunoglobulins A and G. The indirect diagnostic method also evaluates the relationship between the percentage of sperm, but with the titer of antisperm antibodies.

It is important to note that this study is international standard. It is successfully used by specialists around the world. This method is necessary for all couples who really want to become parents.

It is very important to understand the difference between this method and a spermogram. This analysis allows you to assess the ability to fertilize even active sperm.

In the case of a spermogram, they will be marked as healthy or normal. Using the mar test, you can evaluate their suitability or unsuitability for fusion with an egg. This study reveals more "hidden" causes of infertility.

This diagnostic method became possible thanks to the use of mixed agglutination reactions. It is this method that allows us to identify immunological disorders at the level of spermatogenesis.

In what cases is it indicated?

Conduct this examination It makes no sense to absolutely all men. In medicine, for all research there are certain medical indications, including for mar-test.

This laboratory analysis is prescribed when:

planned conception of a child, when both members of the couple are preparing for this event;
presence of infertility;
during planned training before the in vitro fertilization(IVF, ICSI or insemination);
a pathological condition when sperm begin to stick strongly to each other;
consequences of infectious pathologies of the reproductive organs.

What does it show?

This analysis reveals the immunological variant of infertility. In the development of this pathological condition special culprits protein substances– antisperm antibodies. By interacting with sperm, they have a negative effect on them. This leads to male cells cannot perform all the functions assigned to them by nature.

It is important to note where antisperm antibodies are formed. Class A immunoglobulins are synthesized in the male epididymis and testicles. IgG comes from the systemic circulation. They not only “attack” sperm, but also lead to the formation of a special anti-sperm membrane around them.

Scientists have determined in which cases the number of antisperm antibodies increases. This can lead to various injuries and damage to the external inguinal organs.

It often happens that during an examination and history taking, the doctor determines that such an episode occurred in childhood. However, for quite a long time nothing bothered the man. For many years he did not even know that he had such a problem.

Also, various factors can lead to an increase in the level of antisperm antibodies in the blood. infectious diseases. And not only the genitals. Diseases urinary organs are one of possible reasons development of this state. This feature is largely due to the anatomical proximity of the organs.

Surgical operations spent on the scrotum, can also cause an increase in antisperm antibodies in a man’s blood. In this case, the development of pathology is caused by traumatic damage to the anatomical boundary between the blood vessels and the seminiferous tubules.

The “attack” of antisperm antibodies on sperm is facilitated by various disruptions in the functioning of the immune system. The reasons described above lead to such situations. Doctors also associate this process with the fact that the blood-testis barrier (the boundary between blood vessels and testicular tissue) is broken.

In what cases is it not carried out?

As with any research method, there are contraindications for the MAR test. So, this analysis is not carried out if there is practically no complete absence male reproductive cells.

Also, this study is not performed if the sperm count is too low and insufficient in order to fully carry out their calculation.

In this situation, it is almost impossible for the laboratory assistant to study the necessary parameters. In this case, the MAR test will simply be uninformative.

How is it carried out?

The choice of methodology largely depends on how the research will be conducted - direct or indirect. In the first situation, sperm is required directly for the study. To perform the second type of analysis, you will need blood serum.

According to statistics, the direct method of research is used in medical practice somewhat more often. The results of such laboratory tests are more accurate and reliable. However, experts still recommend performing both tests. In this situation, the doctor receives all the information he needs about the properties of spermocytes and the condition immune system.

Usually, this method diagnosis is combined with a spermogram.

To conduct the study, you will need ejaculate. The man collects it through masturbation. There is no need to donate sperm separately for spermogram and mar test. Given a sufficient amount of material, this should be sufficient for both studies.

Before donating sperm for testing, a man should prepare. A couple of days before the examination Do not come into contact with any chemical or toxic substances.

A week before the delivery of the biomaterial, sexual abstinence is prescribed. To a greater extent, this is required so that the husband’s subsequently collected ejaculate does not contain his wife’s vaginal secretion.

2-3 days before going to the laboratory, the consumption of any alcohol-containing drinks is limited. Smoking the day before the test should also be limited. If such a restriction is too severe for a man, then he should not smoke for at least 6-8 hours before donating sperm.

Under the influence of nicotine and alcohol, the studied parameters in the spermogram and the result of the mar-study may change.

Also very It is important to notify your doctor in advance about any medicines the man accepts. Yes, when long-term use hormonal drugs The results of the analyzes performed may be subject to change. If a man has been taking such medications or anabolic steroids for 6-8 months or more, he should definitely consult with his doctor before submitting the material for research.

Also two days before the examination should not actively engage in sports. Intense exercise in the gym can lead to changes hormonal levels. This may contribute to the fact that the results of the study will be unreliable.

If a man is receiving treatment for some diseases of the urinary system, then it is better for him to reschedule this study for a later date. later date. For getting reliable results analysis, doctors advise, if possible, to avoid taking any medications.

It is better to do this at least 8-10 days before submitting the biomaterial.

The turnaround time for analysis may vary. This largely depends on the material and technical base of the laboratory, as well as its workload.

Some medical institutions give out the results of the tests performed the very next day after the delivery of the biomaterial. In others, the readiness of the result, as a rule, is 2-3 days. If rechecking of the analysis is required, it should be repeat test in 2-3 weeks.

Normal indicators

The conditional norm is a condition that doctors call “normozoospermia”. This diagnosis is made after a spermogram.

To establish this condition, it is necessary that the sperm contain 60-150 million male germ cells. At the same time, at least 70% must be active and viable. Doctors most often detect this condition in men under 35 years of age. Unfortunately, the older a man gets, the higher his risk of developing various disorders.

Normal indicators Spermograms are not yet a 100% guarantee of conceiving a baby. The MAR test helps clarify this probability.

If its indicators do not reveal various pathologies, then in such a situation male fertility, as a rule, high.

How are the results deciphered?

The doctor must decipher the results of the analysis. It is quite difficult to do this on your own. Doctors often use special tables that allow them to determine the normal limits of the parameters being studied. This helps the doctor make the correct diagnosis and select the necessary treatment tactics.

The analysis is deciphered in the laboratory by how many antisperm antibodies surround the male reproductive cells. This sign is assessed using a microscope.

If the laboratory technician sees balls in the field of view being studied, this indicates the combination of antisperm antibodies with the sperm. After their visual determination, a quantitative calculation is made. After which normal, active sperm are counted. After this, the percentage of healthy and damaged cells is calculated mathematically. In the future, it is this clinical indicator that will be used by the doctor to establish a diagnosis.

A qualitative analysis also requires that the laboratory technician take into account exactly where antisperm antibodies attach to sperm. Such an attachment can be in the area of the head, body or tail.

How larger area contact, the higher the degree of damage, and the more unfavorable the prognosis for the development of this pathology.

Most a good option the result obtained is negative. It means that the man is healthy and has no signs of immunological infertility. It is important to remember that the parameters of the norm in this situation are very conditional. That is, this suggests that there are no problems with immunological infertility alone. However, even in this situation, this is not a 100% guarantee of conception.

If the test result is negative, this indicates that the sperm contains quite a lot of active and, most importantly, sperm capable of fertilizing eggs. The more healthy male reproductive cells, the higher the male fertility rates.

If after the study a positive result is obtained, then this is a sign that the male body There is serious problems. Typically, such a conclusion is made when more than 50% of sperm are “defective” in their ability to fertilize.

The result obtained is indicated as a percentage. Thus, The higher the percentage, the lower the couple’s ability to naturally fertilize.

Positive analysis is the appearance of 25-50% of male germ cells that are bound by antisperm antibodies. Negative result- this is a situation when the analysis reveals up to 10-25% of such immune complexes. For example, if there is only 0-3% damaged sperm in the sperm, then a man should not worry about this. This indicator considered the norm.

Moreover, the indicators must be assessed separately for each class of immunoglobulins. Normally, for both IgG and IgA, the number of sperm bound by antisperm antibodies will be from 1 to 10%. In some cases, their complete absence occurs. In such a situation, the result of the analysis will be zero.

Increased level class A immunoglobulins (above 40%) indicates that the blood-testis barrier is broken. After it recovers, the igA levels gradually return to normal. This usually takes about a year.

The results of the studies carried out in the majority of men examined are, as a rule, weakly positive or negative. However, it also happens that 100% of damaged sperm are found in the submitted sample. In this case, unfortunately, the probability of conceiving a child tends to zero.

In this situation, they can help the couple become parents modern techniques artificial insemination. In addition, treatment must be carried out.

What should I do?

If you receive a positive test result, it is very important to consult your doctor immediately. It is important to establish the cause that influenced the development of this pathology. For this, the doctor will definitely prescribe additional methods research.

If the cause of the condition is the consequences of previous operations, you should seek advice from the urologist operating on it. In some situations, additional surgical methods correcting any violations that have arisen.

Required condition additional diagnostics is testing for sexually transmitted diseases. It often happens that a man is not checked for the presence of such infections. Many of them quickly turn into chronic form. In this case, it is impossible to achieve a positive result without treating the underlying disease.

All men over 40 years of age should be sure to monitor their prostate health. To do this, you need to visit a urologist at least once a year. During a clinical examination, the doctor will be able to identify enlargements or neoplasms in the organ.

If, based on the results of the mar-test, a man has been diagnosed with immunological infertility, then he should immediately prepare for the fact that treatment for this condition can be quite lengthy.

The complex of therapy includes both medications and physiotherapeutic techniques. It is also necessary to compile individual recommendations about correcting the daily routine, and also selecting the necessary diet.

For more information about what a MAR test is, see below.

Spermogram MAP test is the main method of immune changes in the body. It is used to calculate what percentage of sperm are covered with antibodies (ASAT), to find out their presence in the blood and mucus from the cervix.

When testing the ejaculate, the number of ASATs that are formed in relation to their gametes is determined. Indicators of conventional analysis do not reveal such pathology. A large number of The resulting antibodies are called autoimmune infertility. What the mar test shows, decoding, this is what our article is about.

What is ASAT

Infertility is often caused by problems with the immune system. The spermogram does not show the number of sperm covered with protein balls. What are antibodies and what role do they play?

The immune system is a whole system that protects against various diseases. Destroys everything foreign that comes from outside. Immune cells take part in spermatogenesis, fertilization of the egg. Violation of their interaction leads to the appearance of ASAT in the seminal fluid.

Antibodies in ejaculate were first discovered in 1954 in infertile men. Since then, science has not stood still. Were identified different kinds globulins and their effect on infertility. Great importance depends on where the protein balls are located in the living creature. They are aimed at destroying the cell membrane.

Why do antibodies appear?

The action of the immune system is to destroy everything foreign that enters the body. In men, fluid production begins in adolescence when the protective system has already been formed.

But they are not attacked by their immune system, because they are protected from the blood flow by a system of organs (spermiferous tubules, Sertoli cells) called the blood-testis barrier. Only when this barrier is violated do they penetrate the sperm and act on their own cells, mistaking them for strangers.

Causes of ASAT:

Mechanical damage to the genitals.
Oncological formations.
Operations on the peritoneum, genitals (varicocele).
Cryptorchidism, blockage of the seminal ducts.

How do they affect sperm?

They have a huge impact on the entire reproductive system. From the maturation of germ cells to fertilization. Their influence extends:

Spermatozoa lose their activity and mobility.
Affect morphology.
Blocks penetration into cervical mucus.
Exocytosis—the delivery of sperm to the egg—is disrupted (the inability to cross its surface).

Effect of ASAT on live bait

Antibodies are protein compounds that attach to gametes. A lot depends on the place where they are attached. Their location can be:

On the head.
Middle part.
Ponytail.

By attaching to the cell membrane, they have an inhibitory effect and lead to sperm gluing (agglutination). The more antibodies, the less mobility.

Another important factor is their location. The head of the sperm is considered the most dangerous. By introducing themselves into the membrane, they destroy the integrity of the cell. This leads to her death.

How to take a spermogram and test

If infertility is suspected, the doctor prescribes a MAP test simultaneously with the analysis. When taking it, you must follow the rules in order to get a more reliable result.

It is advisable to do this in a clinic, a specially equipped room, while observing hygiene standards. One week before taking the test you need to:

Do not drink alcoholic beverages, it is advisable not to smoke (alcohol and nicotine contribute to the death of germ cells).
Visiting saunas and baths is prohibited (high temperature disrupts spermatogenesis).
Limit sexual contacts.
Avoid stressful situations, don't get overtired.

The analysis is given in the clinic by masturbation in a special container. Within 45 minutes, the first standard should be ready - the time of ejaculate liquefaction. If you do it at home, you will get a distorted result.

There are many indicators in the spermogram that indicate the condition reproductive system men. To get a comprehensive picture, testing is necessary. If there is agglutination, decoding (MAP) is needed.

Spermogram with MAP - counting of live cells covered with antisperm bodies, which makes sperm inactive and leads to their gluing.

Grade

To find the percentage of defective gametes, ejaculate is taken. Cells with protein balls are counted and their location on the sperm (head, neck, tail) is determined. These indicators determine whether the test is positive or not.

It is considered negative if the presence of antisperm bodies is detected - 10-25%, or they are completely absent. The sperm contains enough healthy gametes ready for fertilization.

Cells that appear to be irregular are counted. Their presence of less than 10% is the norm, negative test. Positive indicates pathology. The higher the percentage of antisperm antibodies, the less likely fertilization. Their number varies from 20-50%.

If the number of morphologically abnormal cells fluctuates 10-40%, conception is possible, but there is some kind of immune failure, the barrier (GTB) is broken. Such deviations are treatable.

The MAP test can show 100% antibodies. In this case, a diagnosis of autoimmune infertility is made. A man has no chance of becoming a father.

DNA fragmentation

In addition to MAP, sperm with a damaged chromosomal chain are considered. If their number is high, this makes conception impossible.

For a more accurate result, it is advisable to take the tests several times with a short break. The results of a DNA spermogram will depend on both internal and external factors.

During spermatogenesis, some gametes have underdevelopment and chromosome DNA breaks. Such cells are removed during development. If this process is disrupted for some reason, the gametes end up in the sperm.

Increased body temperature.
Radiation, chemotherapy.
The effect of heat on the genitals (saunas, baths).
Varicocele.
Acute inflammatory processes.

If external factors will be eliminated, the result will change. A spermogram test is prescribed for patients who long time cannot conceive a child. Thanks to them, you can accurately determine the cause of infertility.

Many abnormalities can be treated with medication, such as varicocele requiring surgical intervention. Reproductive medicine allows couples who have already lost hope to have children. Read new publications on our website.