Antisperm Antibody Testing

Investigation of immunological factor of infertility is based on making tests on presence of antisperm antibodies in semen and in blood plasma in patient and his partner. Standard tests are performed:

• MAR is standard test for detecting percentage of spermatozoids with antisperm antibodies (positive result is 50% of spermatozoids with antibodies);
• IFA (immunofluorescent assay) detects level of antisperm antibodies in blood plasma in patient and his sexual partner.

Positive results of test prove the immune factor of infertility. When another pathologies are not found, the diagnosis of isolated immune infertility, which is found in 10% of marriages, is made. At this stage may be diagnosed varicocele, obstructive azoospermia, and may be detected group of patients with reduced fertility without specification of ethiology at this stage or immunologic factor of infertility. Results obtained at this stage help to narrow diagnostic algorithm of second stage.

On second stage next tests are performed:

• identification of hormonal level is required in patients with azoospermia. It detects the rate of testosterone, follicle-stimulating hormones interstitial cell-stimulating hormone and also sex-hormone that binds globulin which shows not only the amount of testosterone but also its biological activity.
• ultrasound investigation of scrotum organs helps to find structural changes and pathologic growths in testes, adnexas, prostate gland. This test shows changes in seminal vesicles in case of seminiferous paths distal sections blocking or no changes in innate agnesia of spermoduct. Chromatic doppler investigation helps to detect venous hyperemia in the system of spermatic veins and also detects subclinical varicocele.
• identification of urogenital infections agents is made to see if infertility is caused by infection. Indications for this test are: undetermined character of fertility reduction, recurrent pregnancy loss, and also preparation for additional reproductive techniques. Diagnostics of sexually transmitted infections must be made using immunofluorescent assay together with PCR (polymerase chain reaction).
• genetic investigations are made in azoospermia. Karyotyping detects abnormalities in chromosome set. Today becomes popular test which investigates AZF-segment of Y-chromosome. Around 10% of non-obstructive azoospermia cases are connected with dropping of one or several locuses in Y-chromosome on AZT-segment. Genetic investigations provide not only data about genes, but also about the chances that the disease may be transmitted to masculine descents.
• investigations of centrifuged semen and post-orgasmic urine helps to define causes of azoospermia. Investigation of post-orgasmic urine is made in case of retrograde ejaculation.
• seeding of semen is made in pyospermia, and also in case of bad results of spermogram.