When a seminogram is performed and basic seminal parameters such as concentracion, motility, and morphology are checked, other features are evaluated as well, like the presence of sperm agglutination.
Sperm agglutination can be easily observed through microscope. A group of motile spermatozoa are attached to each other. This adhesion is most likely to happen in the head or in the mid piece. However, agglutination in the tail is also feasible. There are mixed agglutinations too, resulting in combinations such as head-tail, head-midpiece, or even midpiece-tail.
It is important to distinguisgh between the terms sperm agglutination and sperm aggregation. When a group of adhered spermatozoa is identified, it is important to see whether the sperm move forward or not. If the attached spermatozoa are actually moving forward, there is sperm agglutination. On the other hand, if the spermatozoa are not moving forward, we have sperm aggregation. In the latter case, sperm present other types of cells: detritus and immature cells attached to the main group.
Sperm agglutination has three grades. Grade 0 represents the lack of attached groups; grade 1 refers to the presence of some agglutination groups, but not higher than 10%. In grade 2, more than 30% of spermatozoa is forming agglutination groups.
Low grades are harmless, but greater agglutination grades impede fertilisation. Since most of the spermatozoa are attached to each other, they cannot reach the egg.
The presence of sperm agglutination may indicate a problem of immunologic sterility. Nevertheless, it is neither univocal nor confirms sterility has an immune origin. When the specialist finds sperm agglutinations, the doctor is duly informed so he/she can undertake as many tests as necessary to diagnose an immune disorder.