Sperm Agglutination

Fertility marker

Agglutination

Sperm Agglutination

Category: Fertility
Unit: grade

Motile sperm sticking to each other, head to head or tail to tail. Distinct from aggregation, where sperm clump to debris or immotile cells.

PED Notes

The reason this is on the report is that agglutination is the classic screening clue for anti-sperm antibodies, an immune cause of infertility that a count and motility check will not reveal. Antibodies can follow testicular trauma, infection, torsion, biopsy or vasectomy including reversal, all of which are more common in this population than average. It is graded rather than measured, so a result of 0 is what you want and anything persistent warrants an anti-sperm antibody test rather than a supplement.

When high

What it suggests: sperm sticking to one another points toward anti-sperm antibodies, which physically impede sperm reaching and penetrating the egg.

Next step is a test, not a supplement:

  • Ask for a direct anti-sperm antibody test (MAR test or immunobead test). Agglutination is the clue; the antibody test is the answer.
  • Consider a cause: previous testicular trauma or surgery, torsion, biopsy, vasectomy or reversal, or genital tract infection.

If antibodies are confirmed: management is a fertility specialist's call. Sperm washing with IUI, or ICSI, bypass the problem directly. Corticosteroids have been used historically but carry real side effects for modest benefit and are rarely first choice.

Also check Total Motility, since agglutinated sperm often read as poorly motile, and Sperm DNA Fragmentation if there has been infection or inflammation.

History Chart

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Frequently Asked Questions

Reference Ranges

Standard Range

Not available

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