What is a MAR test and how to decipher it?

Currently, more and more couples are faced with the difficulty of conceiving a baby. Not always such an intimate problem associated with a woman. It also happens that difficulties with conception are observed in a man.

To diagnose reproductive pathologies that can lead to the impossibility of natural conception, specific studies are required. One of them is the mar-test.

To assess the indicators of male fertility (fertility), several types of research are required. They are appointed by the andrologist or urologist after the extended clinical examination of the man.

During this routine diagnostic procedure the doctor identifies external signs various genital pathologies. If during the examination the doctor suspected some illness, then he will prescribe laboratory tests to the man.

Spermogram and MAR-test are the most common and frequently prescribed types of examinations. In most cases, it suffices only to conduct the first method of research.

Using this analysis, the doctor can determine how mobile and active male sex cells are, as well as determine the number of leukocytes in the ejaculate. This test helps a specialist to get overview of the state of men's health.

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

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

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

It is very important to understand the difference of this method from semen. This analysis allows to assess the ability to fertilize, even in active sperm.

In the case of semen, they will be labeled as healthy or normal. Using the mar-test, one can assess their suitability or unsuitability for fusion with the egg. This study reveals more “hidden” causes of infertility.

This diagnostic method was made possible by the use of mixed agglutination reactions. This method allows to detect immunological disorders at the level of spermatogenesis.

To carry out this survey is absolutely all men does not make any sense.In medicine, for all studies there are certain medical indications, including for the mar-test.

This laboratory analysis is assigned when:

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

This analysis reveals an immunological variant of infertility. In the development of this pathological condition guilty special protein substances - antisperm antibodies. Interacting with sperm, they have a negative effect on them. This leads to the fact that male cells can not perform all the functions laid on them by nature.

It is important to note where the antisperm antibodies form. Class A immunoglobulins are synthesized in male appendages and testes. IgG also comes from systemic blood flow. They not only “attack” sperm cells, but also cause a special antisperm envelope to form around them.

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

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

Also, various infectious diseases can lead to an increase in blood levels of sperm antibodies. And not only genitals. Diseases of the urinary organs are one of the possible causes of the development of this condition. This feature is largely due to the anatomical proximity of the organs.

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

"Attack" sperm antibodies on sperm contribute various disruptions in the functioning of the immune system. The reasons described above lead to such situations. Doctors also associate this process with the fact that the blood-testis barrier (the border between blood vessels and testicular tissue) is broken.

As with any research method, there are contraindications for the MAR test. So, this analysis is not carried out if there is an almost complete absence of male germ cells in the ejaculate.

Also this research is not performed, if the sperm count is too low and not enough in order to fully calculate them.

The choice of the method of conducting depends largely on how the study will be conducted - direct or indirect. In the first situation, sperm is required for the study. To perform the second type of analysis will require serum.

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

For the study will require ejaculate. A man collects it with the help of masturbation.Donating semen separately for sperm and mar-test is not necessary. With enough material, this should be enough for both studies.

Before taking the sperm to study a man should be prepared. A couple of days before the examination Do not contact with any chemical or toxic substances.

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

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

Also very It is important to notify the doctor in advance about what medicines the man is taking. So, with long-term use of hormonal drugs indicators of the tests can be changed. If a man has taken such medicines or anabolic for 6-8 months or more, then he should definitely consult with his doctor before taking the material for research.

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

If a man receives treatment for some diseases of the urinary system, then it is better for him to postpone this study to a later date. To obtain reliable test results, doctors advise, if possible, to exclude any medication.

The term of readiness of the analysis can be different. This largely depends on the material and technical base of the laboratory, as well as its workload.

Some medical institutions issue the results of the tests already on the following day after the biomaterial has been submitted. In others, the readiness of the result, as a rule, is 2-3 days. In case a re-analysis is required, then repeated test after 2-3 weeks.

The conditional norm is a condition that doctors call "normozoospermia." Such a diagnosis is made after the semen.

To establish this state, it is necessary that there are 60-150 million male germ cells in the semen. At the same time at least 70% should be active and viable. This condition is most often detected by doctors in men under 35 years old. Unfortunately, the older a man becomes, the higher his risk of developing various disorders.

Normal semen readings are not at all the guarantor of 100% conception of a baby. The MAR test helps to clarify this probability.

The doctor must decipher the results of the analysis. It is quite difficult to do it yourself. Often, doctors use special tables that allow them to determine the boundaries of the norm of the studied parameters. This helps the doctor correctly diagnose and select the necessary treatment tactics.

The decoding of the analysis is carried out in the laboratory according to how many antisperm antibodies surround male sex cells. This feature is evaluated using a microscope.

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

Qualitative analysis also provides for the laboratory technician to take into account exactly where the antisperm antibodies to spermatozoa are attached. Such an attachment may be in the region of the head, body or tail.

The best version of the result is negative. It means that a man is healthy and has no signs of immunological infertility. It is important to remember that the parameters of the norm in this situation are very conditional. That is, this suggests that there are no problems with immunological infertility alone. However, in this situation it is not 100% guarantor of conception.

If the result of the analysis is negative, it indicates that the sperm contains quite a lot of active and, most importantly, sperm cells capable of fertilizing the eggs. The more healthy male germ cells, the higher the indicators of male fertility.

If after a study a positive result is obtained, then this is a sign that there are serious problems in the male body. Typically, such a conclusion is made when more than 50% of the spermatozoa are “defective” in fertility.

The result is indicated as a percentage. In this way, the higher the percentage, the lower the natural fertilization ability of the couple.

A positive analysis is the appearance of 25-50% of male germ cells, which are bound by antisperm antibodies. A negative result is a situation when up to 10-25% of such immune complexes are detected in the analysis. For example, if in the semen only 0-3% of damaged sperm, then you should not worry about this man. This indicator is considered normal.

Moreover, indicators are evaluated necessarily separately for each class of immunoglobulins. Normally, both in IgG and IgA, the number of spermatozoa bound by antisperm antibodies will be from 1 to 10%. In some cases, there is their complete absence. In such a situation, the analysis will result in a value of zero.

An increased level of class A immunoglobulins (above 40%) indicates that the blood-test barrier is broken. After he recovers, igA will gradually return to normal. It usually takes about a year.

The result of the studies conducted in the majority of the examined men is, as a rule, weakly positive or negative. However, it also happens that in the presented sample 100% of damaged spermatozoa are detected. In this case, unfortunately, the probability of conceiving a child tends to zero.

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

If the cause of the condition has become the effects of previously transferred operations, it is necessary to seek advice from the urologist operating it. In some situations, additional surgical methods are needed to correct the resulting disturbances.

A prerequisite for additional diagnosis is testing for sexually transmitted diseases. It often happens that a man is not checked for the presence of such infections. Many of them quickly become chronic.In this case, to achieve a positive result without treatment of the underlying disease is impossible.

All men over 40 should always monitor the health of the prostate gland. To do this, visit the urologist no less than once a year. During a clinical examination, the doctor will be able to detect an increase or neoplasm in the organ.

If, according to the results of the mar test, the man was diagnosed with immunological infertility, then he should immediately prepare for the fact that the treatment of this condition can be quite lengthy.

Both drugs and physiotherapeutic techniques are included in the complex of therapy. Also, individual recommendations on the correction of the daily regimen are compiled, and the necessary diet is selected.

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