The content of the article:

The probability of conceiving a child depends equally on both the woman and the man. In recent years, there has been an increase in the number of couples who are unable to have children due to male infertility. A man's ability to conceive is known to be related to the number of active sperm in his seminal fluid. According to statistics, approximately 50% of infertile men have disturbances in the functions or development of germ cells. To choose the right treatment, it is necessary to accurately determine the cause of the pathology. For this purpose, a study of the patient's seminal fluid is performed. Standard diagnostic methods are spermogram and MAP test.

When is a MAP test done?

Usually one spermogram is enough to make a correct diagnosis. But there are also cases when the spermogram does not show significant deviations, and the long-awaited conception does not occur. Then they resort to an additional diagnostic method - the MAP test.

Main indications for the MAP test

Indications for performing this study are:

Infertility in men.

Pregnancy planning.

Preparation for IVF, ICSI or insemination.

Bonding of male reproductive cells to each other.

The influence of pathogenic microorganisms on the male reproductive system.

Contraindications for the MAP test

This diagnosis is not indicated in the following cases:

When there is a complete absence of sperm in the semen (as a result of spermogram analysis).

When the number of motile cells in the seminal fluid is too small to evaluate their characteristics.

MAP test - what is it?

MAP test (mixed antiglobulin reaction, MAR-test) is a diagnostic method that allows you to identify a factor of reduced fertility from an immunological point of view. Using the MAR test, the percentage of sperm that are associated with antibodies of the IgG and IgA classes is determined - a direct MAR test and the titer of antisperm antibodies (ASAT) in biological fluids (sperm plasma, blood plasma) - an indirect MAR test. This test represents the internationally accepted standard for diagnosing ACAT.

The Mar test makes it possible to identify motile germ cells (which are defined as normal in the spermogram) as unsuitable or suitable for fertilization. This diagnosis is based on mixed agglutination reactions. A positive result in this case indicates a serious problem.

Immune infertility (which is detected by the MAP test) is spoken of in cases where the majority of active sperm are exposed to antisperm antibodies - immunoglobulins class G and A (IgG and IgA). IgA antibodies are produced locally in the epididymis and testicles, IgG enters the reproductive tract from the blood, they attack sperm and form an antisperm membrane around them.

What is the difference between a spermogram and a MAP test?

Both tests are used to assess a man's reproductive capacity. At the same time, a spermogram is a more superficial study, since it does not allow doctors to obtain all the information about the state of male reproductive cells.

The following situation often arises: all spermogram parameters are normal, but conception does not occur. In this case, an additional diagnostic procedure associated with an immunological study is indicated - the MAP test.

This procedure involves an in-depth analysis of the fertilizing ability of sperm. With its help, you can determine how many germ cells are covered with antisperm bodies. There are cases when the male body synthesizes special antibodies that attack sperm. Male reproductive cells remain mobile, but are no longer capable of fertilization.

A spermogram makes it possible to estimate only the number of immobile and motile germ cells. It is impossible to identify motile infertile sperm (not capable of fertilization) using this analysis. But a spermogram can reveal a connection between infertility and infectious or viral effects.

The production of antisperm antibodies is associated with the following factors:

Presence of infections.

- Injuries to the scrotal organs or surgical interventions, after which the boundary between the vessels and seminiferous tubules is destroyed.

Various pathologies of the genitourinary system.

During normal functioning of the immune system, antibodies or immunoglobulins (special proteins) attack exclusively foreign objects (antigens). But if, under the influence of the factors listed above, any malfunction occurs in the functioning of the immune system, immunoglobulins begin to attack the germ cells of their own body, that is, a violation of the blood-testis barrier (BTB) occurs.

How to take the MAP test

The study can be carried out using one of two methods: direct or indirect. In the first case, seminal fluid is analyzed, and in the second, blood serum is analyzed. The direct method is used much more often because it is more informative. But it is better to perform both analyzes at once, since it is in combination that they provide the most accurate data on the state of sperm and the immune system (that is, they complement each other).

Usually the MAP test is performed in parallel with the spermogram. Material for research is collected through masturbation. There is no need to donate two portions of sperm, since for both studies, samples are taken from the same portion.

Collecting sperm for analysis requires preliminary preparation. To do this, you must strictly adhere to a number of rules. For several days before the test, you should under no circumstances come into contact with toxic compounds. So, if a man’s work involves interaction with chemicals, the test should be performed after a vacation or weekend. In addition, sexual abstinence is recommended 5-7 days before the study. This is necessary so that the material for analysis does not contain the microflora of the partner. It is also highly undesirable to drink alcohol for several days before the test. A few hours before collecting seminal fluid, you will have to give up cigarettes. There is also a restriction on taking hormonal drugs. If a man has taken such drugs over the past 6 months before the analysis, then his results may be greatly distorted.

When there are 1-2 days left before the analysis, you need to ensure complete emotional peace, get a good night's sleep and refrain from heavy physical activity and going to the gym.
If a man is undergoing treatment for inflammation of the genitourinary system, then it is better to postpone sperm testing to a later date.

To obtain a reliable result, you do not need to take any medications or dietary supplements for 10 days before the analysis. Also during this period you should refrain from visiting the bathhouse or sauna. In case of a cold, the test is carried out no earlier than a week after complete recovery.

The container for collecting sperm must be sterile. The collected material must be transferred to the laboratory within an hour. If it takes longer to arrive, the sperm may change their characteristics or die. The results of the analysis in this case will naturally be distorted. In addition, the container with the material must not be refrigerated, otherwise the properties of the sperm may change significantly. Therefore, the best way to donate sperm is within the walls of the laboratory, usually comfortable conditions have been created for this (a separate toilet room with erotic magazines).

How long does it take to do a MAP test?

The wait for the analysis results does not take long; usually the transcript can be obtained the very next day. To be sure of the accuracy of the study, it is advisable to repeat it after 14 days. If the same result is obtained twice, the study can be considered reliable.

Decoding the MAP test

How are MAR test results evaluated?

The result is assessed by how many sperm carry antisperm antibodies. This is visible in the form of immune beads that cover the sperm. These sperm are counted and the percentage of the total number of motile sperm is determined, and the location of the immune beads (on the head, neck, tail of the sperm) is also taken into account. This makes it possible to determine to which parts of the sperm antisperm antibodies are formed.

Mar test is positive or negative - what does it mean?

The results of the MAP study allow us to draw conclusions about the patient’s reproductive capabilities. The norm is a negative test result. It means that a man’s seminal fluid contains a sufficient number of sperm suitable for fertilization. In case of a positive result (when more than half of the sperm have abnormalities), the likelihood of pregnancy is low. This result suggests that the man may be suffering from immunological infertility.

The result of the study is indicated as a percentage. The higher this percentage, the less likely a man is to conceive a child naturally.

A positive MAR test means that 25-50% of sperm are covered with antisperm antibodies, the result varies depending on the laboratory (the norm is indicated on the form).

Negative MAR test - from 0 to 10-25% of sperm are covered with immune beads.
If a certain number of abnormal cells are detected, but they are less than 25-50% of the total number, the man has a chance of conceiving.

The analysis determines IgG and IgA antibodies (percentages for each separately). The presence of up to 10% of spermatozoa with abnormalities in the ejaculate is considered normal. If the analysis transcript contains the phrase “MAP test is negative,” then sperm with defects were not detected, or their number is within normal values, that is, up to 10% for each IgA and IgG group.

From 10% to 40%, fertilization is possible, but some kind of immune reaction is present.

A high percentage of IgA may indicate a disruption of the blood-testis barrier (BTB).
2-3 weeks after the restoration of GTB, the number of these antibodies decreases. High levels of IgG appear approximately 2 weeks after the violation of GTB and remain for up to a year. In addition, the development of antisperm immunity can be caused by urogenital infections that cause cross-immunity.

There are cases when the analysis result approaches 100%. This indicator indicates that a man has practically no chance of paternity. In this case, the andrologist makes a diagnosis of autoimmune or immunological infertility. Then the only option for the couple is artificial insemination or long-term treatment with an unguaranteed pregnancy.

MAP test is positive - what to do

A positive MAP test often indicates the presence of an infectious-inflammatory process in the genitourinary system, so it is necessary to get tested for STIs and tests for prostatitis and conduct additional examination. If a pathogen is detected, complex therapy is required using antibiotics, anti-inflammatory and antihistamines, and physiotherapeutic procedures are also required.

Treatment of autoimmune infertility

If the infectious agent is not detected, then treatment is prescribed according to the following scheme.

Treatment methods for immunological infertility:

Immunosuppressive therapy (prescribe small doses of hormones, for example, corticosteroids for a course of 2-3 months;

Nonspecific desensitization using antihistamines (suprastin, loratadine, tavegil, cetirazine);

Immunostimulating therapy.

conclusions

The MAP study is a laboratory test that is widely used today to identify the causes of male infertility. It is performed in combination with a spermogram and allows an accurate assessment of a man’s reproductive abilities. Thanks to the MAP study, doctors have the opportunity to identify all the factors that led to decreased fertility and prescribe appropriate therapy to the patient.

The combination of a spermogram and a MAP test is an effective way to diagnose male infertility, since these two studies make it possible to identify any variant of decreased sperm fertility.

Tests performed in accordance with all the rules and interpreted by an andrologist provide complete information about the causes of infertility. Based on them, it is possible to reliably assess a man’s chances of conceiving a child naturally and, if necessary, prescribe treatment to the man to improve the quality of sperm.

MAP test: what is it, what is it for and how to decipher it?

A spermogram with a MAR test is a mandatory test in the diagnosis of male infertility. This type of examination is performed to study a man’s fertility in more detail. Taking the test requires preliminary preparation and compliance with the rules. The interpretation of the results is carried out by a specialist and in some cases makes it possible to discover the reason for the lack of pregnancy in his partner.

• Spermogram with MAP test
• What is a MAP test for men?
• Why is the MAR test needed, what does it mean and when is it taken?
• Decoding the results
• MAR test negative: what does it mean?
• What is the difference between IgA and IgG
• How to take the test
• Preparation
• How often should I take it?

Spermogram with MAP test

A spermogram for men is performed to assess sperm activity. Its results may show the following values:

• normozoospermia – a man is capable of conceiving;
• oligozoospermia – there are few sperm in the ejaculate;
• asthenozoospermia – cells are inactive;
• teratozoospermia – cell morphology is impaired.

In addition to the detected problem, a condition such as immunological infertility may be added. It is impossible to determine it with a standard spermogram. The pathological formation of antibodies can be recognized by the MAP test. According to WHO recommendations, the study must be performed every time the sperm is analyzed.

What is a MAP test for men?

To fully assess a man’s fertility, in addition to studying the motor activity of sperm, tests such as a Kruger spermogram, which determines cell morphology, and a MAP test, which detects antisperm antibodies, are prescribed. For men, this analysis is no different from a standard study of sperm composition.

It is often difficult for a man to decide to undergo a diagnosis. After all, even with good spermogram values, the results of the MAP test can show immunological infertility.

Why is the MAR test needed, what does it mean and when is it taken?

The indication for a MAR test is a woman’s inability to become pregnant in the absence of health problems, or preparation for an IVF procedure. The study can also be carried out for a woman: a post-coital test or Shuvarsky test. If the husband and wife have no obstacles to pregnancy, but conception does not occur, then the analysis is done for both partners at once, which allows us to obtain more information about the fertile status of the couple, rather than each individual. The obtained indicators are assessed comprehensively.

What does the MAR test say?

The MAR test helps determine the presence of antisperm antibodies (ASAT) in the body of a man and a woman. Normally, they should not be present in the cervical mucus in women and in semen in men or be found in low concentrations. ACAT can be determined in one or both partners.

The formation of antibodies indicates that the immune system perceives the male germ cells as a foreign object. Normally, human genetic material has 46 chromosomes. The germ cells intended for subsequent fusion include a total of 23. The immune system, detecting them, begins an active fight against the atypical set. Nature designed it so that the body’s defense system does not “see” sperm, but under the influence of certain factors this still happens.

Sperm located in the testicles are protected from immune attacks by the blood-testis barrier. Violation of the integrity of the barrier leads to the formation of antibodies to the structures of the sperm: head, body, tail. Antibodies prevent the sperm from moving and fertilizing the egg.

Violation of the defense mechanism occurs as a result of:

• injuries;
• infectious and inflammatory diseases;
• obstruction of the vas deferens;
• infections suffered in childhood.

It is the MAP test that allows you to identify the body’s defense mechanism and, if possible, carry out treatment.

MAR test and interpretation of the results obtained

If a doctor has prescribed a MAP test, then he must interpret it. You should not try to interpret the numerical values ​​yourself. Often the patient’s opinion about the state of his reproductive system is far-fetched.

Immunoglobulins detected using the MAP test can be of several types:

• IgA – antibodies that are responsible for local immunity and are formed by cells of the mucous membranes;
• IgG – antibodies that are constantly present in the human body when the immune response is formed;
• IgM antibodies, which are primary in the formation of an immune response, are determined in the laboratory only within 2 weeks after formation.

MAP test negative: what does it mean?

If the test shows a negative result, this means that the man is fertile and there is no ACAT in his sperm. The titer of a negative result can vary from 0 to 10%. At the same time, a percentage of 10 to 50 is also the norm, but already doubtful. If an ACAT indicator of more than 10%, but less than 50% is detected, the MAP test is supposed to be repeated no earlier than 2 weeks later.

What does a positive MAR test mean?

If it is possible to detect in the spermogram the number of cells with antisperm antibodies exceeding 50%, then natural conception is difficult for a man. Despite good motility and quantitative composition of sperm, the cells are not capable of fertilization due to the activity of ACAT.

However, even in this case, you should not give up. There is a possibility that you will be able to conceive a child after treatment. Conservative therapy reduces the number of antisperm antibodies and the fertilizing ability of sperm increases.

The decision on the correction method is made by a specialist. In the treatment of antisperm antibodies, the following are used: plasmapheresis, antiglobulin serum, temporary use of latex contraceptives, as well as medications and even surgical methods. If treatment is ineffective, assisted reproductive technologies are used. ASAT can be effectively treated with IVF. When using artificial insemination, 2 treatment options are possible:

• washing sperm from antibodies;
• ICSI.

MAP test IgA and IgG: differences in indicators

When differentiating a pathological process, it is important to distinguish the influence of IgA and IgG immunoglobulins on genetic material. The difference between them is that IgG affects the composition of sperm. These immunoglobulins increase the viscosity of seminal fluid, increase the number of leukocytes, and also sharply reduce acidity. Often in this case the man has a concomitant diagnosis of prostatitis. IgA immunoglobulins reduce the quality of gametes by changing their morphological composition. During the examination of sperm, a mixed type of immunological infertility can be detected.

How to get tested for a man

The material is collected within the walls of a medical institution in compliance with aseptic rules. After collection, the ejaculate is immediately sent for examination. For the patient, the process of sperm collection is no different from a standard spermogram or Kruger spermogram. The difference is obvious only to specialists and is reflected in the results of the study.

Preparation

Before taking a direct test, a man does some preparation. Before a spermogram, you should abstain for a week from alcohol, fatty foods and thermal procedures. You need to observe sexual rest for 2-3 days.

There is an alternative way to determine ASAT - a blood test. This diagnosis is called indirect research. In preparation for it, it is necessary to avoid alcohol a week before the procedure.

How often do I need to take it?

If the result of the reaction is questionable, the man is recommended to retake the test after 2 weeks. It happens that the reason for this indicator is non-compliance with the preparation conditions. If the genetic material is obtained in a small volume or there are no cells in the sperm at all, then it will not be possible to determine the amount of ACAT. If there is any doubt or suspicion of a false result, the patient is prescribed a secondary examination.

The immune system is very important for the body. It is created by nature to protect against germs and viruses. Antibodies destroy all foreign microorganisms that enter the host’s body. The immune system works smoothly and rarely makes mistakes, but sometimes it begins to perceive its own cells as a threat and produce antibodies to fight them.

In men, the object of attack is sperm - male reproductive cells. After such an attack, they are no longer able to fertilize the egg. The structure of sperm is not affected by this problem.

What are antibodies produced by the immune system in response to a threat? These are very complex proteins. They are able to attach to the sperm membrane, greatly “weighting” it. Such a germ cell loses its mobility. As a result, it turns out that the sperm itself has the correct structure, has a flagellum for movement, but cannot move. Over time, he dies.

Deprived of such a “trailer,” sperm move at their proper pace, but if the number of cells attacked by antibodies is large, the chances of fertilization rapidly decrease. The MAP test was developed to reveal the ratio of cells with antibodies attached to them to all motile sperm. The main task of this test is to determine the percentage of healthy sperm that, due to an attack by the immune system, cannot participate in the process of conception.

The patient is offered to undergo a similar test if a regular spermogram does not reveal any abnormalities. If the number of cells bound by antibodies is equal to or greater than fifty percent, the man is considered infertile. In this case, the test result is said to be positive. The higher the percentage, the less chance a man has of becoming a father naturally.

The lower this indicator, the more optimistic medical forecasts are. MAP test is positive, what does this mean? This tells the doctor that the patient’s immune system reacts extremely aggressively to mature gametes and seeks to destroy them; it is very difficult for a woman to become pregnant in such a situation. This type of infertility is called autoimmune.

But the source of antibodies is not always the male body. Sometimes the female immune system reacts in this way to the appearance of sperm. In this case we are talking about immune infertility.

With a negative test, the following picture is created. Mature sperm have half the set of chromosomes, unlike somatic cells. Chromosomes are located in the nucleus and are surrounded by a protective shell, thanks to which the immune system does not notice the reduced number of chromosomes.

That is why germ cells are perceived as ordinary cells of the body. Antisperm antibodies are not produced. Everything is fine and the cells are not attacked. But if inflammatory processes occur in a man’s body, there is a cyst and any other chronic diseases, the protection disappears, and the non-standardity of the germ cells causes an immune response. The protective mechanism is activated, and antisperm antibodies are produced, which strive to bind as many sperm as possible. Spermatozoa lose the motility necessary for fertilization.

The protective reaction of the female body is based on slightly different reasons. Normally, when sperm enter the body, they have no contact with the blood. The presence of mucous membrane prevents such contact. It acts as a natural protective barrier. But if a woman has an inflammatory process or erosion, the integrity of the mucous membrane is compromised.

The immune system responds to the threat and produces antibodies. A positive MAP test in the husband indicates that the doctor should look for an inflammatory process in the patient. First of all, when analyzing the results of a spermogram, attention is paid to low sperm motility. The process of agglutination is observed. This means that two sex cells stick to each other. When encountering antibodies, sperm can accumulate in large quantities in one place. At the same time, all other indicators do not go beyond the norm.

A positive MAR test can be detected during preparation for IVF, ICSI and artificial insemination procedures.

Methodology

There are several conditions when performing this test will not give results. With a small number of motile sperm, it becomes pointless. The test is not performed for necrozoospermia or azoospermia. In this case, the patient must undergo appropriate treatment before the test is prescribed.

It is mandatory to undergo a test in case of sperm clumping. There are two methods of analysis. In one case, sperm is used for it. In the other - blood plasma. In the first case, a direct test is carried out. In the second it is indirect. The most accurate and effective is semen analysis.

To determine whether antibodies to sperm are present, it is necessary to collect seminal fluid. According to the recommendations of the World Health Organization, both a spermogram and a MAP test are carried out simultaneously. A small amount of material is required for analysis. With standard sperm collection, the resulting seminal fluid is sufficient for both analyses.

For the same purpose, mucus from the cervix or, as in the case of a man, blood is taken from a woman. Again, direct examination, which requires mucus, is more accurate. An analysis in which mucus is collected after sexual intercourse is even more accurate. In this case, it is possible to determine how large the number of sperm bound by antibodies is.

Treatment

A positive mar test requires some treatment, but is not a death sentence. Most often, the patient is asked to take a course of corticosteroids. These hormonal drugs are prescribed in small doses for three months. Good results are obtained by taking antihistamines, which include Loratadine, Tavegil, Cetirazine.

If it is still not possible to become pregnant naturally, the couple may be offered conception using assisted reproductive technologies, in particular IVF. This method allows you to prepare sperm and select the highest quality gametes, and the most viable embryos will be used for replanting.

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. In addition to basic tests and spermograms, the Mar test is used when studying male fertility. What does such an analysis mean, when a mar test is used, and how can you understand its results yourself?

The Mar test is a modern laboratory test of sperm that 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 sperm that have normal structure and motility, but have lost the ability to fertilize.

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

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 a complete picture of sperm quality, since it only determines 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.

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

Typically, the mar test is prescribed in situations of unknown causes of 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;
• study of the male reproductive 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 the mar test, he will first have to make an appointment with an andrologist at one of the 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:

1. The sperm samples are mixed with other cells (red blood cells or latex particles) coated with human antibodies (HAT).
2. IgG antiserum is added to the mass of sperm and red blood cells (or latex particles).
3. Spermatozoa, coated with antibodies, stick together with the injected particles.
4. 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. In this process, the woman's cervical mucus is mixed with a sample of the man's sperm 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:

1. For the mar test, ejaculate from masturbation is used. Sperm after sexual intercourse is not suitable for research.
2. If you take hormones later than six months before the test, the test results may be distorted.
3. 10 days before the test, visiting the sauna or bathhouse is excluded.
4. 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.
5. Avoid contact with toxic substances 2-3 days before the test (when working in hazardous conditions, contact with chemicals, etc.).
6. Avoid the use of spicy and fatty foods.
7. 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.
8. Ensure rest and avoid any overexertion the day before the test.
9. Avoid alcohol for a week and smoking 3-4 hours before the test.
10. Organizing proper sleep the day before the analysis.
11. If a man has had ARVI or influenza, the test is not performed until he has fully recovered.
12. Before donating sperm, you must urinate and wash your genitals with soap. When masturbating, do not use lubricant or use a condom.
13. Particular attention is paid to the issue of collecting material for the test. The sperm is collected in a sterile container. In this case, 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.
14. 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.
15. 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 interpreted by a reproductive health professional. When reading the transcript of this study, it is important to know that:

• a negative result is a good test indicator;
• a positive result is a bad result.

An important factor in decoding 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 a sufficient number of full-fledged sperm remain in the seminal fluid. And this is great, since this couple has a great 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 less chance of paternity the test man has.

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 such a response equates to a high probability of 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, the use of IVF or IVF + ICSI techniques in such situations allows 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 with modern capabilities of assisted reproductive technologies, conception is possible even with a 100% positive mar-test.

Male infertility is no less common than female infertility. One form of infertility is immune.

With such a violation, sperm cannot move fully, since there are antibodies on their surface that form an antisperm membrane around the germ cell. And to determine whether there is such a problem, patients undergo MAR test(“MAR” - “Mixed agglutination reaction”, that is, a mixed agglutination reaction).

In our clinic, doctors will help you solve this problem.

Where do antisperm antibodies come from?

Sex cells differ in structure, genetic make-up and other features from other cells in the body. This dissimilarity is dangerous because the defense system may regard the sperm as hostile objects that should be disposed of. This is why the seminiferous tubules in a healthy body are separated from the blood vessels by the blood-testicular barrier.

As a result of certain diseases and injuries of the genitals, this barrier may be broken. As a result, the reproductive system (vas deferens, epididymis, etc.) begins to produce protective substances, the aggression of which is directed against sperm. The amount of antibodies determines how much a man’s ability to conceive is impaired.

How can you determine the presence of antibodies?

The presence of antisperm antibodies can be assumed not only by the results of the MAR test, but also by. Impaired motility of germ cells or the presence of agglutination, albeit indirectly, indicate immune.

The MAR test can be performed together with the determination of other spermogram indicators or separately. But the patient must have the result of a spermogram on hand, since a test for antisperm antibodies is carried out to clarify the data of the ejaculate study. However, if there has been testicular injury, dropsy, or other factors that increase the likelihood of antibody production, a man may be prescribed two tests at the same time.

How to prepare for the analysis?

2-5 days abstain from intimate contacts, do not drink alcohol and do not overheat (do not visit the sauna, bathhouse).

The delivery of material is carried out by masturbation. The ejaculate is collected in sterile plastic containers. In the laboratory, it is mixed with antiserum, which is capable of binding antisperm immunoglobulins IgA and IgG. If the semen contains antibodies, they will react with the serum to form antigen-antibody complexes. A specialist can see them under a microscope.

How to decipher MAR test results?

If there is a small number of antibodies on the sperm, this is considered a relative norm. With 10-30% of “attacked” germ cells, the situation is not considered critical. Despite the loss of the ability to fertilize so many sperm, conception is still possible.

And if there are 50% or more of sperm covered with antibodies, then the MAR test is considered positive. This means that the man has immune infertility. Although this is not an easy situation, it can be managed with the right treatment.

What to do if the test is positive?

Don’t despair and don’t look for folk remedies on the Internet.