Sperm Agglutination and Aggregation in Spermogram

Sperm agglutination is the sticking together of motile spermatozoa by their heads, tails, or heads with tails. The type of agglutination (by heads, by tails, or mixed variant) is noted on the form, and the degree of agglutination is assessed semi-quantitatively: “–” – no agglutination; “+” – weakly expressed (single spermatozoa are stuck together); “++” – moderate (up to 50% of spermatozoa are stuck together, but only by heads); “+++” – markedly expressed (50% of spermatozoa are stuck together, both by heads and by tails); “++++” – severe degree (almost all spermatozoa are stuck together). 👉🏻Normally, in practically healthy patients, there is no agglutination. The presence of agglutination suggests immunological mechanisms (presence of anti-gamete antibodies) as a cause of infertility; however, additional studies must be conducted to prove this fact. ❗Sometimes, during microscopy of a native preparation, chaotic clusters of immotile spermatozoa are visible, piled up on clumps or strands of mucus, cellular elements, and detritus. This phenomenon is called pseudoagglutination (aggregation) and is not taken into account in the analysis. Source: Novikova I.A. - Introduction to Clinical Laboratory Diagnostics - 2018