How does agglutination affect fertility

According to the information you provided, probably there are no risk factors like genital infection, genital trauma, post vasectomy and testicular torsion etc. It seems that other tests are normal so if there is no pregnancy even after trying for about 1 year then you should probably undergo Antisperm Antibody testing in semen. What Is Zika Virus? Here's All You Should Know. Close [X]. Am i infertile or there is some problem with my sperm?

Web Stories. Home Remedies. Why do I get cuts on my frenulum during intercourse? Cuts on the foreskin of penis What is the normal range of pus cells in the urine of children? The concentration can be estimated roughly during the initial examination in order to determine the dilution procedure to be used and to indicate whether centrifugation may be required to prepare an adequate smear for morphologic analysis.

The ejaculate usually contains cells other than spermatozoa. These include polygonal cells from the urethral tract.

If many of these are present, and they are covered with bacteria then it is probably that the sample was obtained by coitus interruptus and the cells originate from the vagina 6.

Spermatogenic cells and white blood cells WBC , which are often referred to as "round cells", are present in almost every semen sample. By conventional light microscopy or sperm staining techniques it is not possible to reliably differentiate WBC from immature germ cells in semen.

In contrast, the cytochemical peroxidase method reliably identifies granulocytes, the most prevalent WBC type in semen The method is cheap, fast and easy to perform. The gold standard for the detection of all WBC populations in semen is immuno-cytology using monoclonal antibodies However, it is expensive and time-consuming, thus remaining a research tool at present. For clinical purposes, the peroxidase method is ideally suited to detect granulocytes. The method 11 aims at the counting of peroxidase-positive round cells in a haemocytometer.

This solution is mixed before use and can be conserved for 24h after preparation. The procedure consists of mixing 0. This mixture is shaken for 2 min. It is then left for min at room temperature and mixed again by shaking. The mixture is now transferred onto a haemocytometer chamber for leukocytes and the number of peroxidase-positive cells which stain brown is counted.

Peroxidase-negative cells remain unstained and are counted in the haemocytometer chamber. The differentiation of round cells into either peroxidase-positive polymorphonuclear granulocytes or peroxidase-negative spermatogenic cells or lymphocytes is of clinical relevance.

The presence of an excessive number of peroxidase-negative mostly spermatogenic cells suggests pathology at the level of the seminiferous epithelium with inadequate spermatogenesis and premature release of spermatids spermatocytes or, rarely, spermatogonia. The pathological meaning of the presence of an elevated number of WBC is still a matter of dispute. Some reports have demonstrated that leukocytospermia appears to be of no diagnostic value to identify men with actual microbial infections Also, measurement of seminal leukocytes in routine semen analysis appears to be of little prognostic value with regard to male fertilizing potential Others hold the view that the presence of an elevated number of WBC may be associated with infection or inflammation of the accessory glands 6 and that the unfavorable effect on spermatozoa of hydrogen peroxide secreted by peroxidase-positive WBC has clearly been proven 6.

A comprehensive approach that considers other clinical and laboratory findings seems to be more reliable in detecting male accessory gland infection 4. Agglutination of spermatozoa means that motile spermatozoa stick to each other, head to head, midpiece to midpiece, tail to tail, or mixed, e.

The adherence of either immotile or motile spermatozoa to mucus threads, to cells other than spermatozoa, or to debris is not considered agglutination and should not be recorded as such 6, 24, The presence of agglutination is suggestive of, but not sufficient evidence to prove the existence of an immunological factor of fertility 6, 24, The extent of agglutination may be important but even the presence of only a few groups of small numbers of agglutinated spermatozoa should be recorded.

In case of agglutination, sperm culture must be performed in order to exclude infection with e. Escheria coli. Sperm agglutination could be used also as indication for antisperm antibody testing of infertile men 6, Vital staining of the spermatozoa allows quantification of the fraction of living cells independently of their motility 4.

Live and dead sperm are distinguished by adding one drop of eosin y stain to one drop of semen at room temperature one to two minutes and smearing the mixture on a microscopic slide This staining technique makes it possible to differentiate spermatozoa that are immotile but alive from those that are dead Reduced percentage of motility with a high percentage of viable sperm may reflect structural or metabolic abnormalities of sperm that are derived from abnormalities in testicular function or antimotility factors in the seminal plasma This technique also provides a check on the accuracy of the motility evaluation, since the percentage of dead cells should not exceed the percentage of immotile spermatozoa The hypo-osmotic swelling HOS test measures sperm membrane integrity by examining its ability to swell when exposed to hypo-osmotic media, and has been claimed to be relevant to fertilizing ability 4.

The rationale of the test is based on the assumption that an undamaged sperm tail membrane permits passage of fluid into the cytoplasmic space causing swelling and the pressure generated leads to curling of tail fibers, while the damaged or chemically inactive membrane allows fluid to pass across the membrane without any accumulation and accordingly no cytoplasmic swelling and curling of the tail occur. The HOS test should not be used as a sperm function test but may be used as an optional, additional vitality test It is simple to perform and easy to score and gives additional information on the integrity and the compliance of the cell membrane of the sperm tail The stain needs not to be included if a phase-contrast microscopy is used.

If the preliminary examination of the semen indicates that the concentration of spermatozoa present is either excessively high or low, then the extent to which the sample is diluted should be adjusted accordingly. An optional procedure for determining sperm concentration employs specialized counting chambers, e. Makler chamber. The total number of spermatozoa per ejaculate reflects spermatogenesis and is related to the duration of sexual abstinence 4.

Perhaps the most widely utilized semen parameter is sperm count. It simply takes them a substantially longer period of time to achieve pregnancies 1. Although the morphological variability of the human spermatozoon makes differential sperm morphology evaluation very difficult, observations on the selection of spermatozoa recovered from the female reproductive tract especially in post coital cervical mucus helped to define the appearance of a normal spermatozoon.

The normal head should be oval in shape. Allowing for the slight shrinkage that fixation and staining induce, the length of the head should be 4. The length-to-width ratio should be 1. There must be no neck, midpiece or tail defects and no cytoplasmic droplet more than one-third the size of a normal sperm head. This classification scheme requires that all borderline forms be considered abnormal The traditional feathering technique whereby the edge of a second slide is used to drag a drop of semen along the surface of the cleaned slide may be used to make thin smears of spermatozoa.

The Papanicolaou smear for staining of spermatozoa is the method most widely used in andrology laboratories. We have reported that these methods are not as elegant as the Papanicolaou method but allow the classification of the spermatozoa in the main groups with the same accuracy Physical sperm aberrations may occur during the production of sperm or during storage in the epididymus.

In cases of teratozoospermia, one should start first by excluding the presence of monomorphic genetic syndromes such as globozoospermia, microcephaly and short tail spermatozoa 4.

The increased number of immature spermatozoa may be due to epididymal dysfunction or is a consequence of frequent ejaculations. The increased number of spermatozoa with tapering heads are found in association with varicocele. In a recent study we have reported that the percentage of tapered spermatozoa, spermatozoa containing cytoplasmic droplets and spermatozoa with bent tail are significantly increased in varicocele patients compared to controls According to the literature the importance of sperm morphology as a single and independent predictor of in-vivo and in-vitro fertilization seems to be proven The presence of anti-sperm antibodies in semen can alter the fertilizing ability of the spermatozoa.

Being haploid ,sperm cells are immunogenic and display different surface antigens from their diploid counterparts 4. When this barrier is ruptured, sperm cells induce the synthesis of anti-sperm antibodies 4. The presence of sperm antibodies coating the spermatozoa is typical of and is considered to be specific for immunologic infertility 6.

There are some data suggesting that IgA antibodies may have greater clinical importance than IgG antibodies. The screening test for antibodies is performed on the fresh semen sample and makes use of either the Immunobead method or the mixed antiglobulin reaction test MAR test.

Immunobeads are polyacrylamide spheres with co-valent bound rabbit anti-human immunoglobulins. Spermatozoa are washed of seminal fluid by repeated centrifugation and resuspended in buffer. The sperm suspension is mixed with a suspension of Immunobeads. A monospecific antihuman-IgG antiserum is added to this mixture. The formation of mixed agglutinates between particles and motile spermatozoa proves the presence of IgG antibodies on the spermatozoa Sperm antibodies could influence sperm function in a variety of ways.

For example, sperm agglutination and immobilizing antibodies might limit the number of fertile sperm cells at the site of fertilization Antibody production against sperm surface macromolecules could interfere with critical physiologic fertilization precursor events, such as capacitation and the acrosome reaction It is also possible that antibodies produced against essential intraacrosomal enzyme systems, such as proacrosin-acrosin could impair sperm penetration through egg investment Infection of the genital tract, varicocele, cryptorchidism, testicular torsion and auto-immune disease are the most frequent conditions associated with antisperm antibodies There are various biochemical markers of accessory gland function, e.

A low secretory function is reflected in a low total output of the specific marker s , which may therefore be used for the assessment of accessory gland secretory function.

An infection can sometimes cause a considerable decrease in the secretory function of these glands