Sperm agglutination may be a reflection of a possible immunological factor, observing the presence of spermatozoa joined together at some point in their structure (head, intermediate segment or tail), giving rise to head-head, tail-tail or mixed agglutination. The presence of this phenomenon is usually related to a decrease in fertility.
The male history should be taken into account in the assessment of the same, such as seminal tract obstruction, vasovasostomies or bacterial suspicion. The presence of antisperm antibodies in patients diagnosed with oligozoospermia may reflect the presence of unilateral obstruction of a seminal duct. The presence of such antibodies in infertile patients may be associated with chlamydial and mycoplasmal infections.
Another type of "false agglutination" or pseudo-agglutination is the agglutination of spermatozoa together with various cellular debris, mucous fibres or other cells, without relevance.
Once an agglutination has been correctly detected in the counselling sample, it is necessary to quantify it by assessing the percentage of motile spermatozoa that agglutinate and those that do not. If more than 10 % of spermatozoa are found to be affected, a more precise quantitative assessment of the sample is required using direct antispermatozoa antibody detection techniques. Anti-sperm antibodies are mainly of the IgA, IgG and IgM types, with IgA being the most widely secreted. These antibodies may be present in the male or in his partner.
Antisperm antibodies can be detected in the blood of both men and women, although detection in seminal plasma or cervical mucus is usually more relevant.
Reference values depend on the methodology used such as the determination of binding activity, the presence of immunoglobulins and complement-dependent immobilisation. The most commonly used technique is probably the use of immunobeads, with the presence of sperm motility being necessary for their evaluation.
