Sperm agglutination (mixed): treatment. What is agglutination in the spermogram and how to treat the problem? Spermatozoa stick together

The date: 07.06.2022

Sperm agglutination is a concept in medicine that characterizes the process of sticking of active spermatozoa to each other and / or with other sperm components. This pathology negatively affects the course of fertilization of the egg, since “sticky” spermatozoa cannot enter it.

The causes of the disease are varied and are the result of underlying diseases, so a man who discovers a problem should immediately go for a diagnosis.

Sperm agglutination is not considered a disease as such, however, it is recognized as a pathology, the untimely treatment of which or the absence of it can lead to impotence, the birth of unhealthy children, and is also one of the causes of infertility. Sperm

Depending on the nature of the gluing of male gametes, experts distinguish several types of spermatozoa agglutination:

true (specific) - sperm cells stick together with each other in the area of \u200b\u200bthe head or flagella, which is why they cease to be mobile;
false (non-specific) - male gametes stick together with other components of sperm, which also leads to immobilization of gametes. This type of agglutination is called "aggregation".
mixed sperm agglutination - aggregation and agglutination are observed simultaneously, which happens in very rare cases.

Mechanism

The spermatogenic epithelium of the seminiferous canals is the location of gametes in the male body. Sertoli cells, which create a hemotesticular barrier, are responsible for ensuring that blood does not enter the seminal fluid, as well as with the immune system.

When the Sertoli cells fail, a “gap” appears in the barrier, which causes the contact of the spermatozoa and the immune system. Gametes, like sex cells, have a half set of chromosomes, which the immune system recognizes as incorrect, defective, alien.

The process of their destruction is launched by the production of antibodies - special proteins that adhere to the surface of spermatozoa, which have a charge with a "-" sign.

Bodies with a negative charge tend to repel each other, however, enveloping protein antibodies destroy charged gametes, causing them to stop repelling, which leads to gluing with each other, as well as with other fractions of the ejaculate.

Causes of malfunction of Sertoli cells

Agglutination is not a disease and is one of the symptoms of an underlying disease that negatively affects the functioning of the hemotesticular barrier.

The main reasons for gluing gametes are as follows:

damage and compression of the genital organs of a man. From this, a violation in the nutrition of Sertoli particles can occur, as a result of which they die and cause an inflammatory process;
an inflammatory process that causes the appearance of bacteria that feed on healthy cells;
hormonal disruptions that negatively affect the production of testosterone, which is responsible for the formation of seminal fluid, and with it spermatozoa;

diseases of the genitourinary system that increase the creation of agglutinated gametes and increase the density of sperm;
a malfunction of the immune system, which lowers the degree of protection of the hemotesticular barrier, which is why sperm are falsely taken for foreign bodies and destroyed by antibodies;
mumps or mumps, in children.

In addition to the above factors, the result of which is the adhesion of spermatozoa, there are other causes of the pathological process:

violation of the process of ejaculation;
varicose veins affecting the testicles (varicocele);
genetic predisposition;
anemia;
drinking alcohol and using drugs;
some medical preparations.

Diagnostics

The clinical picture of sperm agglutination is expressed in only one symptom - difficulty conceiving. It is possible to identify pathology only with the help of diagnostic studies, which take place in two main stages.

Stage one - MAR test

For the MAR test, both venous blood and seminal fluid are taken as a material. The study helps to determine the number of affected gametes, as well as their ratio as a percentage of the total.

Stage two - spermogram

Spermogram is the most informative and reliable study of the composition of the ejaculate and its ability to fertilize.

Sperm parameters are studied:

viscosity;
volume;
color;
the possible presence of blood and its components and similar characteristics;
sperm motility and their condition are determined.

Stage three - other general analyzes

Carrying out other tests and diagnostic methods, such as:

blood sampling;
urine;

They allow to determine the causes of the pathology and the disease that caused the sperm to stick together.

Both in the first and in the second stage, the main method of taking material for analysis is self-masturbation. It is very important that the sampling is carried out correctly, since the seminal fluid tends to change the degree of density.

The maximum period during which the material must be examined is three hours. In addition, sperm should not experience sudden temperature changes, under the influence of which spermatozoa may die, and the analysis itself will become unreliable.

On the basis of research, a preliminary diagnosis is confirmed or refuted - spermatozoa agglutination, and its degree is also revealed.

Degrees of agglutination and semen quality

According to the qualitative composition, “healthy” sperm should not be thick and contain lumps.

According to the World Health Organization (WHO), normal quantitative and qualitative indicators of sperm are:

the volume of seminal fluid is more than two milliliters;
the number of active spermatozoa - at least half of the total;
the number of "healthy" gametes - at least thirty percent.

The mark "abs" in the spermogram means the absence of pathology. If there is a deviation from the normative indicators, then the disease is present.

The degree of agglutination is of four types:

1 degree - isolated (+) - the presence of small groups of agglutinating spermatozoa in the amount of not more than five units in each;
2 degree - medium (++) - several small groups of agglutinating spermatozoa in the amount of ten to twenty units each;
3 degree - severe (+++) - large groups of agglutinating spermatozoa in the amount of more than twenty units each;
Grade 4 - the most severe (++++) - in the studied volume, almost all spermatozoa that are in a motionless state are glued together, as indicated by the value of "d" of the spermogram.

Based on the identified characteristics of agglutination, the specialist prescribes the necessary therapy.

Treatment

Treatment of agglutination and aggregation of spermatozoa is prescribed by a urologist after all diagnostic studies have been carried out and in the case when the cause of the pathology is found. There are several types of therapy that directly depend on the degree of the disease.

Medical

Conservative treatment with medications is carried out in the diagnosis of inflammatory processes in the body of a man.

Antibiotics are prescribed, aimed at the destruction of various types of pathogenic bacteria, and with them drugs aimed at reducing inflammation.

Such a complex of treatment leads to the cleansing of dead cells and the restoration of sperm properties. If the infection is localized in the prostate gland, then the doctor may prescribe the following medications, such as:

Prostamol uno;
Prostanorm;
Vitaprost.

Conservative treatment is also used for hormonal failures. Hormone therapy is prescribed, aimed at increasing testosterone levels through the use of appropriate drugs.

In some cases, treatment is aimed at increasing sperm motility and eliminating antisperm proteins. For this purpose, drugs such as gonadotropin and clomiphene are prescribed.

Surgical intervention

Operations to eliminate agglutination and aggregation of spermatozoa can be used when the genital organs are affected by vascular diseases, for example, varicocele, or other diseases, such as:

torsion of the testicular cord;
prostate adenoma.

ethnoscience

Traditional medicine, as well as a diet, an active lifestyle, are recommended for mild agglutination, but pathology cannot be treated with folk remedies alone.

Healers advise the use of mummy, which should be washed down with natural berry juice, as well as the regular use of herbal teas and decoctions.

Such measures can help in raising immunity, reducing the degree of inflammatory processes in the body, etc.

Conception and pathology

Small degrees of pathology leave a low probability of fertilization, but doctors do not recommend using it either, since there is a high risk of having a child with genetic abnormalities.

Successful treatment can completely restore the quality characteristics of the ejaculate while maintaining the ability to fertilize, however, in most advanced cases, sperm quality cannot be restored.

Both cases involve the process of filtering the sperm, after which it is introduced into the egg in the manner prescribed by the chosen method of fertilization.

Prevention

To reduce the risk of sperm clumping, a man should take the following preventive measures:

include in the diet foods containing vitamin C, which improves digestion;
avoid damage to the genitals, in particular, the testicles;
lead a healthy and active lifestyle and give up bad habits;
do not expose the body to high and low temperatures;
avoid wearing tight and synthetic underwear that can pinch the testicles;
if possible, do not apply lubricant during intercourse;
have sex regularly
undergo examinations of the genitourinary system at least once a year in order to detect deviations and pathologies in time.

The development mechanism is simple:

Damage to the blood-testicular barrier.
Attack of sperm by natural antibodies.
Production of antisperm bodies.
Clumping of sperm.

Cause of sperm agglutination is a violation of the function of the blood-testicular barrier, or shield, which does not allow the immune system to find the formed sperm.

Each sex cell has exactly half of the required chromosomes. For this reason, the immune system regards them as inferior, which means they are alien, to be destroyed. It is the natural antibodies in the blood serum that begin to "attack" the cells of the seminal fluid, incl. and the sperm themselves.

In addition, in case of violation work of the hematotesticular barrier, the immune system "finds" the sperm and, trying to destroy them, begins to actively produce specific proteins - antisperm bodies, which in turn, attaching to the surface of the sperm, destroy its tiny negative charge. Because of this, the sperm can no longer repel its own kind and collides and sticks together with other cells and particles present in the ejaculate.

Due to the variety of factors affecting spermatogenesis, there are also many reasons for the occurrence of sperm agglutination:

Causes of dysfunction of the hematotesticular barrier

Hematotesticular barrier is a physical barrier between the blood vessels and the seminiferous tubules. It consists of specific Sertoli cells.

The reasons causing the destruction of the protective blood-testicular barrier include a number of factors:

Injury to the texticles (testicles).
Infections of various etiologies (of various origins).
Various complications after surgical intervention in the reproductive organs.
Inflammatory processes in the organs of the male reproductive system.

It follows from this that the phenomenon of sperm agglutination is only a pathology accompanying the underlying disease, a kind of symptom.

Diagnosis of the disease

Diagnose agglutination spermatozoa can only be in the laboratory. To do this, a man needs to donate a certain amount of sperm with Kruger morphology. Before examining the spermogram, the patient must undergo a MAR test.

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Treatment of agglutination

Treatment for such a pathology carried out only after all the necessary analyzes and studies. This is due to the fact that agglutination itself is not an independent disease, but only accompanies the underlying disease and is only a symptom (as mentioned above).

Based on the true pathology, the doctor draws up a treatment regimen. If necessary, the doctor can and should correct it.

With an inflammatory process complex medical conservative treatment (without surgical intervention) is carried out. Previously, if we are talking about an infection, studies are carried out to identify the causative agent of the disease (bacteriological examination or serological, and, if possible, titration of antimicrobial agents)
In case of diagnosis of varicocele, expansion of the veins of the pampiniform plexus or other diseases requiring the participation of a surgeon - they carry out appropriate treatment adequate to the diagnosis. At the same time, like any other surgical disease, they are treated not only with a scalpel, but also with appropriate medications.
Sometimes a doctor uses hormone therapy to treat. As a rule, this method is aimed at artificially increasing the level of testosterone in the body of a man.
They also use folk recipes, diets, sports. With a slight agglutination of sperm, this method is most preferable.

The influence of sperm agglutination on the possibility of conception and methods of treating pathology

Sperm agglutination can not but affect the process of conceiving a child. Having even a slight degree of agglutination, you should refrain from trying to get pregnant.

Also, do not forget about other sensitive points on the female body. And the first one is the G-spot.

You can find out the rest of the secrets of unforgettable sex on the pages of our portal.

Conception with a high degree of agglutination cannot occur, but with a small one it is possible. But as a result of such a pregnancy, there is a high probability of giving birth to an unhealthy child with chromosomal disorders.

slight agglutination is successfully cured by drugs under the supervision of a physician, and the ability of sperm to fertilize the egg normally is fully restored.
If the degree of agglutination is high, the treatment may not give the desired effect, because agglutination in this case is caused by some of the previously listed extensive pathological conditions. In such cases, doctors recommend IVF (in vitro fertilization) or ICSI (intrauterine insemination method)

What to do if sperm agglutination is detected?

If you have identified sperm agglutination, you need to contact a urologist or andrologist. The doctor will prescribe the necessary detailed examination, and later, based on its results, treatment. The doctor will also explain how you need to change your diet and, possibly, lifestyle for a successful cure for this disease.

If a couple fails to have a child for a long time, it is necessary to decide and undergo an in-depth examination to determine the cause of infertility. Perhaps the cause is sperm agglutination. It is necessary to do and find out if there is agglutination in the spermogram. The results of such a survey can provide an assessment of the state of men's health. After that, the doctor will decide on the possibility of treatment or artificial insemination.

Agglutination in the spermogram: what is it?

What can she tell the profile doctor?

The term "agglutination of spermatozoa" (seminal cells) refers to the pathology of the male reproductive system, in which cells stick together. In the normal state, these seminal cells move and repel themselves under the influence of negatively charged particles. This ensures their mobile behavior necessary to reach the egg and fertilization.

Stand out:

True agglutination, in which spermatozoa stick together with each other.
False (nonspecific) agglutination. In this case, spermatozoa stick together with particles of destroyed cells, lumps of mucus, epithelial cells, and antibodies of their own body.

What are the reasons for the development of this pathology?

The blood-testicular barrier can be damaged in some male diseases:

damage to the testicles as a result of trauma;
complications of surgical interventions;
diseases of the male reproductive organs.

What consequences does this pathology have for a couple who want to have children?

Glued cells lose the ability to move forward to the egg. Therefore, fertilization of the egg does not occur. If doctors detect sperm agglutination, it is considered necessary to carry out bacteriological seeding of sperm. This is necessary to assess the potential threat of infection. It is necessary to determine whether it can lead to sperm agglutination and male infertility. Bonding of spermatozoa does not allow fertilization to occur.

What is the diagnosis of the state of the ejaculate in this pathology?

Detects different degrees of this deviation from the norm. You can detect it using a spermogram. The direction for this analysis is given by the andrologist.

How is sperm agglutination determined?

This examination of male sperm is carried out using a microscope. It is considered the only and main analysis to predict male fertility. But the spermogram does not give an unambiguously negative result. Even serious differences from normal characteristics only mean a lower ability to conceive a child in the usual way.

What should be done to properly prepare for a spermogram?

Abstinence from sexual activity for 2-7 days.
Refusal to take alcohol, drugs, coffee for the same period.
During the same period, you can not take water procedures, sunbathe and allow exposure to high temperatures on the body.

How is the material for spermogram collected?

ejaculate is collected in a condom using masturbation. The laboratory room is equipped with a specially designated room with a door securely closed from the inside and erotic magazines;
the collected material must be transferred to laboratory assistants no later than within three hours from the moment of ejaculation;
for a more accurate result, this material is submitted for research repeatedly.

Evaluation of the results of this analysis:

The spermogram must necessarily contain an indication of the degree of sperm agglutination (agglutination). It is expressed as a number of pluses.
The patient should not be discouraged if a poor result is obtained in the course of this study. Spermogram should be done again. The following characteristics of his sperm may be different.
If, as a result of this analysis, the presence of pathological agglutination of spermatozoa is established, it can be considered that there is:

failure of the immune system;
manifestation of an autoimmune inflammatory process;
chronic inflammatory process in the male gonads.

Can a man with such an analysis result become a father?

Agglutination in the spermogram does not exclude the possibility of conceiving a child naturally. But reduced sperm motility is observed in almost all cases.

What to do if sperm agglutination is detected

What is the treatment? How to treat sperm agglutination?

What is the essence of these methods of overcoming infertility:

antibodies that stick together the seminal cells are separated from the spermatozoa;
the seminal fluid is washed out to make the cells mobile again;
provided that there is a sufficient number of active spermatozoa, sperm is introduced into the uterus using a catheter;
as a result of this short-term procedure, the likelihood of fertilization increases significantly;
this reproductive technology is called artificial insemination.

Sometimes fertilization by artificial insemination cannot be realized, since the man does not have a sufficient number of seminal cells. Then such a process is carried out in a test tube. The female eggs are extracted and combined with the washed male spermatozoa. But this does not always have the desired result.

In this situation, there is the possibility of fertilization using intracytoplasmic sperm injection. This is a successful, but much more expensive and complex reproductive technology. But it is of great importance for people who want to have a child.

Almost every man dreams of a child. This is a great happiness for the family, but not always the couple manages to conceive children in the usual way.

Modern medicine has great potential to help people in such situations.

If you make a spermogram, you can identify the causes of male infertility. Simultaneously with the spermogram, other studies are also carried out. Sperm agglutination can be cured. The doctor finds ways to treat and conceive a child.

You never need to despair. There are always ways to achieve the best result. You just need to be patient and persistent. Modern reproductive technologies have already helped many couples. There are many possibilities for treatment. And then a small miracle will appear in the family: a pretty girl with pigtails or a mischievous boy. Life will be filled with new meaning.

Infertility is a real tragedy in the lives of both women and men. Modern studies show that in half the case, infertility occurs due to the fault of the stronger sex. And not the last place here is the quality of male sperm.

What is sperm agglutination

Simply put, this is a phenomenon in which the necks, heads or tails of spermatozoa stick to one another or to different fractions of the ejaculate. This pathology can be detected only with the help of a spermogram.

In a healthy state, spermatozoa are negatively charged and, according to the laws of physics, repel each other - accordingly, during their passage through the female genital tract, gluing does not occur. And sperm agglutination is the absolute inability of spermatozoa to overcome the female genital tract and fertilize the egg.

Varieties

If the natural mechanism of the genital organs is disturbed, two types of this pathology are possible: true or false agglutination. Both are dangerous for the occurrence of infertility.

Important! Sperm agglutination can lead to impotence or cause diseased offspring.

True

With true agglutination, spermatozoa (gametes) stick together with one another in any parts. Male germ cells lose their lability and functionality, as a result - the development of male infertility.

False

Or nonspecific agglutination. Male germ cells are not glued together with each other, but with parts of the seminal fluid - mucus, epithelial cells, macrophages. As a result, sperm cells also lose their mobility, and fertilization becomes impossible.

The mechanism of development of pathology

The start of the development of this pathological process is the appearance of antisperm bodies on the surface of gametes. It is they who immobilize and glue the gametes.

Normally, gametes are located in the seminiferous tubules, in their spermatogenic epithelium. Existing Sertoli cells (also called hematotesticular barrier) prevent sperm from coming into contact with blood and prevent sperm from coming into contact with the male immune system - it identifies them as foreign substances.

Did you know? During ejaculation, the speed of a man's sperm is 70 kilometers per hour.

Sometimes the hemato-testicular barrier ceases to function and the gametes come into contact with the immune system, which, recognizing spermatozoa as foreign bodies, expels these cells from the body. Antisperm bodies are formed - special proteins that occupy specific areas on the outer surface of the male sex gametes. Their unusually strong bond with sperm alters their function and practically immobilizes them.

Causes

The main causes of this pathology are:

testicular injury;
reduced immunity;
abnormality of the sex glands;
unsuccessful surgical interventions;
autoimmune processes;
infectious diseases;
inflammatory processes in the genitals;
transformation of the structure of sperm;
varicose veins of the spermatic cord;
ejection of semen into the bladder;
obstruction;
hormonal disorder;
homozygosity;
anemia and cystic fibrosis;
underdevelopment of the genitals;
drugs and alcohol;
some medicines;
venereal diseases.

Important! If appropriate treatment is not carried out in time, this is fraught with the loss of a man's ability to procreate.

Diagnostics

The main method for diagnosing this anomaly is a spermogram., in the output of which, among other things, the degree of gluing is indicated:

+ - gluing into groups of no more than five sperm, it does not matter much;
++ - bonding in separate groups from 10 to 20 spermatozoa;
+++ - there are more than five groups, each of which contains dozens of spermatozoa;
++++ - many gluing groups, each with a large number of cells.

Another diagnostic method is the MAR test. With its help determine the fertilizing ability of sperm. This test is considered negative when the number of sperm that carry antisperm antibodies is not more than 50%. In the case of an increase in their content to 80-100%, artificial insemination is recommended.

When sperm agglutination is detected, the doctor finds out its origin: the underlying disease is diagnosed, which led to the appearance of the pathology, and its treatment is prescribed - medication or surgery.

VIDEO: INTERPRETATION OF SPERM GRAM INDICATORS

Therapy Methods

This ailment is considered by experts to be a serious disease that requires appropriate treatment. His treatment is based on spermogram data and the causes of the pathology.

Surgery

This type of treatment is prescribed in case of sperm sticking as a result of physical trauma to the genitals. The essence of the operation is to eliminate gluing with the help of surgical intervention.

In addition to the operation itself, this type of treatment requires the patient to take medications that improve sperm quality.

Important! The operation is carried out only if the elimination of adhesion is really probable.

Medical treatment

Drug therapy that improves sperm is used if the patient has infectious diseases that contributed to the appearance of gluing of sperm. A man is prescribed antibiotics, anti-inflammatory and antibacterial drugs, the main task of which is to relieve inflammation. In addition to this, drugs are prescribed that strengthen the body and increase its resistance.

Diet

With this ailment, you will have to change the diet and follow these recommendations:

Eliminate fatty protein foods, replacing them with fresh fruits and vegetables, as well as foods high in folic acid - leafy vegetables, wholemeal bread, yeast, liver.
Increase the intake of vitamin C, which affects the vitality and tone of sperm, as well as its volume.
Reduce alcohol consumption, and three to four months before the planned conception - completely abandon it. In return, "lay down" on white cabbage and bran.
Limit yourself to beer. This drink is detrimental to sperm quality.
Fried foods should not be in the diet. It should be replaced with stewed or steamed.
Load up on fruits and vegetables, which, thanks to the high amount of antioxidants, have a positive effect on fertility.
Strengthen the diet with vitamin E - eat more celery, cilantro, parsley, honey and dried fruits. This will improve blood vessels and sperm.

Did you know? The length of the spermatozoon is only 0.055 mm.

What is the probability of successful conception after recovery

A small degree of agglutination under the supervision of a doctor is successfully cured and the possibility of spermatozoa to normal fertilization of the egg is completely revived.

With a small degree, there is a certain possibility of conception, but this is associated with the risk of having a child with a chromosomal failure. However, with a high degree of agglutination, when adhesion is a consequence of the pathological conditions mentioned above, the result of treatment can be disappointing. In this case, in vitro fertilization or intrauterine insemination is recommended.

Thus, sperm agglutination is a serious problem for men's health, but you should not despair and give up. In many cases, this disease can be successfully treated. You should not be afraid to seek medical help in a timely manner, and then follow all the doctor's instructions.

Agglutination is a pathological process that provokes the gluing of spermatozoa. Agglutination in the spermogram is one of the analysis options that reflects the presence of fused spermatozoa and the degree of their gluing. Agglutination is associated with consequences expressed in the impossibility of fertilization of the egg by sperm. Depending on the stage and form of the pathology, the patient may be prescribed both a course of drug therapy to restore reproductive ability, and the need for artificial insemination.

Origin mechanism

Depending on the features, two types of agglutination are distinguished: true and false. True agglutination in the spermogram reveals the presence of spermatozoa stuck together. The fusion of spermatozoa is partial, if the male sperm is glued together by the head or tails, and complete, when the sperm is unsuitable for fertilization. The consequence of pathology is the loss of sperm motility.

False agglutination according to the spermogram reflects the process of gluing spermatozoa with particles of lymph, mucus, epithelium, as well as other components that sperm contains. Pathology also provokes the loss of sperm mobility, but in most cases, the ability to fertilize in men remains. It is much easier to cure this variant of the pathology. Normally, the processes of maturation of spermatozoa occur in the spermatogenic epithelium, which serves as a natural barrier between male germ cells and hemalymph. This is due to the fact that sperm cells are alien to the body due to the haploid set of chromosomes.

When the natural protective barrier is violated, the immune system begins to produce anti-sperm antibodies that affect sperm antigens. The result of pathogenic factors is the process of gluing spermatozoa with the subsequent loss of the ability to fertilize the egg with sperm.

What will the doctor say after the examination

Sperm agglutination is a serious disease and requires treatment. The lack of adequate therapy leads to the loss of the ability of men to procreate. The spectrum of causes of sperm agglutination is small. For example, the following factors can lead to the appearance of adhesion displayed on the results of the spermogram, which the attending physician will help to detect and determine:

Surgical manipulations in the genital area of a man, which led to the development of complications or were carried out incorrectly.
Infectious, viral, bacterial and inflammatory diseases of the reproductive system.
Mechanical injuries of the genital organs of a man, associated with damage to the seminal canals, can also become one of the prevailing causes.

To confirm the diagnosis, you need to conduct a spermogram.

Spermogram is used as the main type of diagnosis to detect the disease. In accordance with the results of the spermogram in a man, mixed, true or false sperm agglutination can be determined. In the form of an additional study, a MAR test is used to determine sperm motility, their number and the presence of gluing.

Medical therapy

Each patient who, according to the spermogram, has a pathology, is interested in the question: how to treat agglutination and improve sperm. The treatment of a man is selected in accordance with the data of the spermogram and the reasons that led to the development of the pathology. The results obtained after the therapy depend both on the correctness of the chosen treatment and on the degree of manifestation of the pathology.

If a patient is diagnosed with infectious diseases that contributed to the agglutination of sperm, drug therapy is selected that improves sperm. The patient is prescribed antibiotic, anti-inflammatory and antibacterial agents that eliminate the inflammatory process. Additionally, it is necessary to take drugs whose action is aimed at strengthening the body and increasing its resistance.

If sticky spermatozoa or agglutination in the spermogram is the result of physical trauma to the genital organs, it is possible to eliminate the adhesion through surgical intervention. The operation is carried out only if there is a possibility of removing the adhesive. It must be remembered that such treatment includes taking medications in order to improve the sperm in a man.

The treatment of any kind does not guarantee positive dynamics. However, if there is such a need, even with bonding, there is the possibility of conception. In the most mild cases, sperm is improved by filtration. The method allows to partially or completely restore sperm motility and mechanically eliminate sticking.

If the cause of the disease is an infectious disease, drug therapy is prescribed.

If, after applying the method, success was not achieved, which was confirmed by spermogram data, artificial insemination is required. In accordance with this method, purified sperm is introduced into the uterine cavity using a sterile catheter. The method of in vitro fertilization is also used. The optimal technique is chosen purely individually in each case.

ethnoscience

Alternative treatment is not among the methods effective in the treatment of sperm agglutination. However, taking some homemade medicines can improve sperm, increase a man's ability to conceive, and reduce the ability of sperm to clump together. Among the most simple, safe and effective recipes are:

Psyllium seeds brew a glass of boiling water and put on low heat for ten minutes. Strain the broth, take 50 grams at least four times a day. It improves sperm.
Excellent helps with infertility and to improve the quality of sperm natural mummy. Take this tool should be daily, in the amount of 0.5-1 grams. You can drink juice or purified water.
To eliminate agglutination, you can replace the usual tea with a decoction of herb mountaineer. To do this, mix a spoonful of dry raw materials with a glass of water, and then cook for ten minutes.

Alternative methods of treatment have one plus: they have no contraindications. The combination of therapy will help achieve the desired result, that is, the restoration of a man's ability to conceive and obtain positive spermogram results.

As additional, but the most important measures, one should name proper nutrition, giving up bad habits, and a healthy lifestyle in general. This will help improve sperm.

If the treatment does not bring an effect, the man still has a chance to have offspring. Methods of artificial insemination in most cases lead to a positive result even with advanced forms of agglutination. For the procedure, purified sperm is used. Often, fertilization requires three to four procedures.

Agglutination in the spermogram is a pathology in which a man loses the ability to naturally conceive. With agglutination, the spermatozoa are attracted to each other, the cells stick together. In the normal state, this does not happen, since gametes have a negative charge. When sperm stick together, motor activity is disturbed and genetic material is damaged.

What does the term mean

Sperm agglutination can be detected in a man during a spermogram. In this condition, the various parts of the germ cells stick together. During the analysis of sperm with multiple magnification, the specialist sees clots and lumps from spermatozoa. In a healthy man, the cells repel each other and move one at a time. Pathological adhesion leads to reduced fertility, but does not always mean infertility. It is important to determine the degree of change in order to assess the prospect for correction.

Aggregation and agglutination are terms that often appear together. The difference is in the mechanism of cell adhesion. If, during agglutination, spermatozoa are attracted to each other, then aggregation is accompanied by foreign inclusions sticking to gametes.

Experts subdivide agglutination into true, false and mixed. Depending on which one is found in the patient, the fertility status, the method of correction and the prospect of natural conception are determined.

True

With true agglutination, glued sperm are found in the male seminal fluid. They can join each other with the whole body or separate parts. Sticking together of tails reduces the motor activity of cells. If the spermatozoa join heads, then the risk of damage to the genetic material increases.

With the true form of the disease, the fertility of a man decreases. In some cases, infertility is determined and there is no chance of natural conception.

False

The mechanism of development of agglutination in the false form is different. In this case, the spermatozoa are adjacent to each other through a biological conductor. Direct gluing of body parts does not occur. Mucus, epithelium, leukocytes or other impurities are found between the spermatozoa.

With false agglutination, the prognosis is more favorable. To select an effective method of treatment, doctors conduct an in-depth diagnosis, which allows you to determine the causes of sperm adhesion.

mixed

With a mixed type of agglutination, germ cells stick together with each other independently and with the help of a conductor. Usually, during a spermogram, a laboratory assistant detects an accumulation of sex gametes mixed with mucus and other biological substrates.

The reasons

Experts believe that the main provocateur of agglutination is a violation of the hematotesticular barrier. It is necessary to protect spermatozoa from the aggressive effects of their own immune system. The blood-testicular barrier is located between the seminiferous tubules and blood vessels. Due to the physical barrier, spermatozoa do not have direct contact with the body's defense system.

If the barrier is violated, the immune system recognizes "non-standard" cells and takes them for a foreign object. The special structure of spermatozoa explains these processes.

Unlike all cells of the human body, sex gametes have not 46 chromosomes, but 23.

Causes of violation of the hematotesticular barrier:

chronic sexually transmitted infections;
inflammatory processes in the pelvic organs;
surgical operations performed on the testicles;
testicular injury;
mechanical damage to the integrity of the seminiferous tubules;
congenital anatomical features of the structure of the genital organs;
hormonal disorders;
prolonged use of toxic drugs;
neoplasms in the pelvis.

Diagnostics

Visually, aggregation and agglutination in the spermogram are not manifested in any way. The adhesion of spermatozoa does not change the organoleptic properties of seminal fluid. Only with a severe form of the inflammatory process and extensive gluing of gametes, the presence of lumps in the sperm can be noticed.

To diagnose the pathology, an extended spermogram with a MAR test is performed. The study reveals antisperm antibodies, which become the main cause of germ cells sticking together. During the diagnosis of sperm, the classification of the pathological process is used:

(+) - one plus says that there are less than ten glued cells in the seminal fluid sample;
(++) - reports that the number of gametes stuck together is from 10 to 50;
(+++) - indicates that more than 50 cells with agglutination were found;
(++++) - assigned to sperm in which all spermatozoa are glued together.

If all sperm counts are normal, and no adhered cells are found, the doctor makes a conclusion about normozoospermia. In the "agglutination" column, the laboratory assistant can indicate the abbreviation abs or put a dash.

Probability of conception

In case of violation of the integrity of the hematotesticular barrier, it is possible to assess the prospect of natural conception only after an extended examination. It is important to determine what caused the problem. Depending on the cause, the doctor will select a correction method. In medicine, there are many examples when agglutination was cured with the help of medicines.

If sperm do not stop sticking together after treatment, and there is no prospect of natural conception, doctors recommend methods of assisted reproductive technologies.

Treatment

Sperm agglutination is treated according to an individual scheme.

Since the most common cause of gluing of germ cells is chronic inflammation and infection, it is necessary to be examined. If the pathogen is identified, antibiotic therapy is prescribed.
Hormonal disorders require appropriate therapies. After determining the hormonal status, an individual dosage of the necessary drugs is selected.
With obvious violations of the immune system, regulatory therapy is carried out. To prescribe treatment, you need to contact an immunologist.
Surgical intervention is required for varicocele, seminiferous tubule injuries and other serious pathologies.
Vitamins, biological additives, herbal preparations are prescribed as auxiliary means. They increase the activity of spermatozoa and increase the likelihood of natural conception.

Before treating agglutination, the patient is advised to obtain the conclusion of an andrologist, urologist, immunologist. With a low effectiveness of therapy, you will have to seek help from a reproductologist. Methods of assisted reproductive technologies allow even those men who have a minimum of spermatozoa in the spermogram to become fathers.

In a normal process, spermatozoa are endowed with a negative charge and during their movement, they repel each other. With various pathologies, they begin to stick together or stick together.

Types of agglutination

There are 2 types of agglutination, they can be detected in the process of semen analysis.

True

The gums are glued together in parts, tails, heads, or completely with both tails and heads.

Clumped sperm cannot fully fertilize the female egg, as the ability to move and functions are lost, which leads to infertility.

Nonspecific

In this pathology, the spermatozoa stick together with the particles contained in the semen.

They also lose speed and the spermatozoa stuck together are not able to fertilize the egg.

How the process develops

The development of pathology is observed when ASAT appear on spermatozoa. These are anti-sperm antibodies because of them, the spermatozoa stick together and stop moving.

In the male body, sperm are located in a special channel where they do not have contact with the blood. The channel is guarded by special Sertoli cells that form the hematotesticular barrier.

This barrier protects spermatozoa not only from contact with blood and other substances, but also prevents contact with the immune system. Since she reacts to spermatozoa, as to foreign elements in the body.

If the barrier fails, the immune system detects the sperm in the body and tries to expel them. Therefore, ACAT is being developed to combat foreign substances.

Antisperm antibodies, by their nature, are special proteins that occupy certain places on the surface of male sex gametes.

Their connection with spermatozoa is quite strong and does not allow the latter to move and perform their functions.

If you understand what agglutination in a spermatozoon is, then this is the complete immobilization of spermatozoa, their inability to move along the female genital tract and fertilize an egg.

If during the examination of a man, even small changes and the beginning of agglutination are noticed, the doctor prescribes treatment and monitors the course of the pathology.

If during the examination of the sperm, agglutination in the spermatozoon is noticed, then the man is diagnosed with infertility and additional tests for antisperm antibodies are performed. A number of additional tests are also prescribed, which will be able to determine whether there is an infection in the man’s body that provoked agglutination.

Even a slight sticking of sperm indicates that the man's immune system is impaired and urgent treatment is required. You should not postpone it, as the presence of antibodies in the sperm of a man can lead to problems with conceiving a healthy child.

Of great importance for the fertilization of a female egg is what type of agglutination is observed in a man. If this is true, then there will be no fertilization, if.

Spermatozoa stick together with other particles. This does not affect fertilization, but the movement of the gums slows down, which is why they cannot always reach the goal.

Causes of pathology

The reasons for which pathology can develop are varied, in order to establish them, you need to undergo an examination and consult a doctor.

Why contact with blood occurs:

In the body of a man, inflammatory processes began;
Possible complications after surgery;
If there were testicular injuries;
For sexually transmitted diseases.

If a gap appears in the barrier, the immune system notices the spermatozoa, which store only part of the man's DNA in themselves, which is why they are considered alien to the body and an active fight against them begins.

The development of mixed agglutination is also possible, but this is an extremely rare pathology.

Diagnosis of the disease

To diagnose the disease, the doctor prescribes special procedures.

Which includes:

spermogram;
Analyzes;
Additional research.

In the spermogram, they look at the number of spermatozoa, their activity, mobility, and also examines the volume of sperm, its viscosity. Liquefaction rate, color. Be sure to take into account whether there is mucus, blood, additional impurities in the liquid.

To take tests for laboratory research, the ejaculate is taken by self-masturbation. You can collect the material in the laboratory, it will be better, but also bring it from home, but be sure to remove it in warm weather and bring it for examination within 1 hour.

Degrees of agglutination

In the results, you can see the degree of pathology:

+ low degree no more than 5.
++ 10-20 pieces.
+++ a few dozen.
++++ high degree.

If a man has a large number of sperm that stick together, this indicates infertility or a chronic disease that requires immediate treatment.

If the semen contains no more than ++ antisperm antibodies, then this does not affect fertilization. A man is not considered infertile and can conceive a healthy child on his own.

If the degree of agglutination is higher, this can greatly slow down the movement of spermatozoa and, in fact, their inability to reach the female egg.

Doctors often use the term - normozoospermia, this is the norm in the qualitative or quantitative composition of sperm.

What is considered normal:

The volume of sperm excreted is at least 2 ml;
The number of active spermatozoa in it is at least 50%;
Normally developed morphological gums from 30%.

If the test shows poor results and large numbers of damaged morphological spermatozoa, it is not recommended to continue trying to conceive without a specially selected treatment, since poorly developed spermatozoa can lead to the conception of a sick child.

MAR test

Before a doctor prescribes a spermogram, a man needs to undergo a MAR test.

The MAR test is a special study that analyzes the percentage of those spermatozoa that are affected by antisperm antibodies. This study shows how many gummies are losing their function. In relation to their total number.

The test helps to identify if there are normal gums in the sperm that are capable of fully fertilizing the egg.

To pass the test, you need to pass not only sperm, but also blood from a vein, both analyzes must be taken at the same time, as they complement each other.

A positive test is considered if the amount of antisperm antibodies exceeds 50%.

Treatment

After studies have shown the presence of sticky gums, the doctor determines the diagnosis and may prescribe a course of therapy. Treatment is prescribed based on the cause due to which agglutination began.

If the cause of the pathology lies in an infectious disease, a course of treatment with medications is prescribed. All of these have a positive effect on sperm quality and can help reduce agglomeration.

If the pathology is caused by processes that require surgical intervention, then an operation is performed. But before the intervention, the doctor prescribes medications.

If the cause of the pathology is not inflammatory processes, a man may be prescribed cleaning of the seminal fluid using filtration. If this does not help, the man's sperm is cleaned and the intrauterine method is used. This method helps a woman to conceive a child.

Usually, treatment has positive results and sperm functions are restored.

If all methods have proven ineffective and a man is diagnosed with infertility, the only way to become a father is to take advantage.

Medical

In most cases, the patient is prescribed medication that restores sperm function and helps to conceive a healthy child.

Depending on the cause of the pathology, the doctor prescribes various drugs.

Traditional medicine recipes

Together with medicines and traditional medicine recipes, the doctor prescribes a special diet for the patient. To improve the quality of sperm, some fruits and vegetables that are high in vitamin C, such as kiwi, oranges, cabbage, and currants, should be added to the diet.

On an empty stomach, drink 0.2 g of mummy, while drinking them with juice from fresh fruits and berries;
Instead of tea, drink decoctions of various herbs;
Drink a tea rose decoction 1 tablespoon 3 times a day.

It is not advised to self-medicate and all means should be reported to the attending urologist.

Conclusion

Agglutination is a pathology that requires treatment. With timely and properly selected therapy, infertility can be avoided and a healthy child can be conceived.

Video: Spermagglutination, asthenozoospermia

is a detailed analysis of the ejaculate, during which its macroscopic, microscopic and physico-chemical examination is carried out. This test is carried out in specialized clinics and laboratories for those men who have problems conceiving.

The analysis has many parameters, one of them is the presence or absence of agglutination.

Photo 1. Agglutination is one of the reasons why there may be difficulties in conceiving a child. Source: Flickr (LifeUnfold Healthcare and Lifestyle).

What is agglutination in spermogram

Agglutination is a required parameter, which is indicated in the spermogram. There may be five different signs next to it:

Agglutination is an immune response during which the interaction of the antibody (immunoglobulin) with the antigen occurs, their connection and precipitation of the immune complex. Such a reaction occurs in the body in response to foreign agents, such as bacteria, entering the bloodstream.

Note! Normally, there should be no agglutination in the spermogram, its appearance means that antibodies to spermatozoa are present in the seminal fluid. Normally, these antibodies are not produced in the body.

Types of pathology

Agglutination can be false and true.

False

In this case, we are not talking about agglutination, but rather about aggregation. Spermatozoa precipitate due to interaction with other cells. This happens when there is a breach. . At the same time, there are no antibodies in the seminal fluid, opposite to agglutination in the spermogram is + or ++.

At repeated delivery, as a rule, this pathology is not detected.

True

In this case does an immune response occur? and spermatozoa are affected by antibodies that agglutinate them. In the spermogram opposite the corresponding parameter can be from + to ++++, depending on the severity of the reaction and the amount of immunoglobulins.

Photo 2. For an accurate result, it is recommended to conduct a semen analysis 2-3 times. Source: Flickr (Christian Witte).

Reasons for the development of the problem

The main reason for the appearance of true agglutination is education in the body antisperm antibodies and their entry into the seminal fluid.

For these immunoglobulins, the target antigen is spermatozoa.

It is interesting! Spermatozoa have an antigenic composition that is different from body cells. They are foreign bodies in the male body. There is a hematotesticular barrier between germ cells and immune cells. Normally, the immune system does not encounter spermatozoa and antibodies to them are not produced.

Violation of the blood-testicular barrier can be observed in the following cases:

congenital inferiority genital organs;
Endocrine pathology;
Acute or chronic inflammation of the urinary tract(epididymitis, orchitis, prostatitis);
Testicular injury;
Surgical operations on the genitals.

Symptoms and signs of agglutination

This pathology may not affect the health of the man himself. The only symptom is difficulty conceiving a child.

There may be manifestations indicating the cause of agglutination. For example, pain in the scrotum or lower abdomen, difficulty urinating, weak erection.

However, more often these manifestations are absent and the cause is identified through a detailed study of the anamnesis and additional studies.

Methods for diagnosing a problem

Agglutination can be detected by microscopic examination of seminal fluid and a series of tests. In order to distinguish a true reaction from a false one, it is necessary to detect antisperm antibodies. There are several ways to identify them:

MAP test. For its implementation, latex particles coated with antisperm serum are added to the seminal fluid. In the event that there is ASAT on the surface of the spermatozoa, they will stick together with the latex particles and precipitate with them.
ELISA. This test is performed to detect ASAT in a man's blood. To do this, antibodies to ACAT labeled with the enzyme are added to the blood serum, and then a substrate for this enzyme. If the reaction between the substrate and the enzymes did not occur, then there are antisperm antibodies in the man's blood. With true agglutination, ASAT always appears in both semen and blood.

Additionally, it is necessary to conduct examinations to identify the cause of this pathology. For this, surrender general urine analysis, spend Ultrasound of the pelvic organs, carefully examine the prostate, testicles and their appendages.

Treatment of agglutination in men

To get started, you need to reanalysis in compliance with all the rules for the delivery of biological material. In the event that the presence of agglutination is again confirmed, it is necessary to start treatment. Therapy should be prescribed by a doctor, based on the causes of this problem.

Most often treat primary pathology, for example, inflammation of the organs of the reproductive system.

In addition, the doctor may prescribe to improve the quality of sperm.

There is no specific therapy for this pathology.

Does the disease interfere with the ability to have children

A small degree of agglutination may not affect reproductive function in any way.. If a sufficient amount of free spermatozoa remains in the ejaculate, fertilization of the egg is possible.

Problems arise when if agglutination scores three or four plus. Then the sperm cells stick together instead of moving towards the egg. Such gametes are not capable of fertilization. In this case possible IVF.

During IVF, spermatozoa are freed from antibodies in the laboratory, and then placed on the egg. Sometimes, for a married couple, this is the only way to conceive a child.

Author Oleg Dobrolyubov

Candidate of Medical Sciences

What is sperm agglutination

Varieties

If the natural mechanism of the genital organs is disturbed, two types of this pathology are possible: true or false agglutination. Both are dangerous for the occurrence of infertility.

Important! Sperm agglutination can lead to impotence or cause diseased offspring.

True

With true agglutination, spermatozoa (gametes) stick together with one another in any parts. Male germ cells lose their lability and functionality, as a result - the development of male infertility.

False

The mechanism of development of pathology

The start of the development of this pathological process is the appearance of antisperm bodies on the surface of gametes. It is they who immobilize and glue the gametes.

Did you know? During ejaculation, the speed of a man's sperm is 70 kilometers per hour.

Causes

The main causes of this pathology are:

testicular injury;
reduced immunity;
abnormality of the sex glands;
unsuccessful surgical interventions;
autoimmune processes;
infectious diseases;
inflammatory processes in the genitals;
transformation of the structure of sperm;
varicose veins of the spermatic cord;
ejection of semen into the bladder;
obstruction;
hormonal disorder;
homozygosity;
anemia and cystic fibrosis;
underdevelopment of the genitals;
drugs and alcohol;
some medicines;
venereal diseases.

Important! If appropriate treatment is not carried out in time, this is fraught with the loss of a man's ability to procreate.

Diagnostics

The main method for diagnosing this anomaly is a spermogram., in the output of which, among other things, the degree of gluing is indicated:

+ - gluing into groups of no more than five sperm, it does not matter much;
++ - bonding in separate groups from 10 to 20 spermatozoa;
+++ - there are more than five groups, each of which contains dozens of spermatozoa;
++++ - many gluing groups, each with a large number of cells.

VIDEO: INTERPRETATION OF SPERM GRAM INDICATORS

Therapy Methods

This ailment is considered by experts to be a serious disease that requires appropriate treatment. His treatment is based on spermogram data and the causes of the pathology.

Surgery

In addition to the operation itself, this type of treatment requires the patient to take medications that improve sperm quality.

Important! The operation is carried out only if the elimination of adhesion is really probable.

Medical treatment

Diet

With this ailment, you will have to change the diet and follow these recommendations:

Eliminate fatty protein foods, replacing them with fresh fruits and vegetables, as well as foods high in folic acid - leafy vegetables, wholemeal bread, yeast, liver.
Increase the intake of vitamin C, which affects the vitality and tone of sperm, as well as its volume.
Reduce alcohol consumption, and three to four months before the planned conception - completely abandon it. In return, "lay down" on white cabbage and bran.
Limit yourself to beer. This drink is detrimental to sperm quality.
Fried foods should not be in the diet. It should be replaced with stewed or steamed.
Load up on fruits and vegetables, which, thanks to the high amount of antioxidants, have a positive effect on fertility.
Strengthen the diet with vitamin E - eat more celery, cilantro, parsley, honey and dried fruits. This will improve blood vessels and sperm.

Did you know? The length of the spermatozoon is only 0.055 mm.

What is the probability of successful conception after recovery

A small degree of agglutination under the supervision of a doctor is successfully cured and the possibility of spermatozoa to normal fertilization of the egg is completely revived.