MAR test

The MAR test is a key study in male infertility that can reveal hidden immunological causes of difficulty conceiving. With timely detection and appropriate behavior, the chances of success increase significantly.

MAR test — test for antisperm antibodies in male infertility

The MAR test (Mixed Antiglobulin Reaction) is a specialized laboratory test that detects antisperm antibodies (ASA) — immune proteins that bind to sperm and can impair their motility and fertility.

What are antisperm antibodies?

Antisperm antibodies are immune molecules that recognize sperm as “foreign” and attack them. They can:

Connect to the glans — disrupt the penetration of sperm into the egg;
To attach to the tail — worsen the motility of spermatozoa;
To form agglutinates — they bind sperm together and block their movement.

When are antisperm antibodies formed?

Normally, sperm do not come into contact with the immune system. But in certain situations, the blood-testicular barrier is disrupted and an immune response is activated. This can happen in:

Varicocele;
Injuries or operations in the testicle area;
Infections (orchitis, epididymitis);
Obstruction of the vas deferens;
After vasectomy or reversion;
Autoimmune diseases.

How is the MAR test carried out?

Collection of a seed sample after 2—5 days of abstinence;
Addition of special latex particles coated with antihuman immunoglobulins (IgA or IgG);
Microscopic analysis — checks whether the particles bind to the sperm;
Estimation of the percentage content of antibodies.

How are the results interpreted?

The results are presented as a percentage of sperm associated with latex particles.

Процент свързани сперматозоиди	Интерпретация	Клинично значение
< 10%	Нормален резултат	Липса на значимо количество антиспермални антитела. Няма имунна пречка за оплождане.
10–50%	Гранична стойност	Наличие на антитела с потенциално влияние върху подвижността. Необходима е клинична преценка.
> 50%	Положителен резултат	Високо ниво на антиспермални антитела. Вероятно влошена оплодителна способност. Препоръчва се ICSI.

A MAR test may be performed for IgA and/or IgG antibodies depending on suspicion.
A high MAR score does not exclude the possibility of fertilization, but significantly reduces the likelihood of natural conception.
ICSI (intracytoplasmic sperm injection) is the preferred method in a positive MAR test.

When is the MAR test recommended?

In male infertility with an unclear cause;
With normal spermogram, but failure in conception;
In case of abnormalities in the motility or agglutination of spermatozoa, established in the standard spermogram;
After operations, trauma or inflammation in the scrotum.

What do we offer in our clinic?

In the Invitro Clinic “Sofia” MAR test is performed according to an established laboratory protocol, with evaluation of both IgG and IgA antibodies if necessary. We provide:

Interpretation of results;
Individual treatment plan in the presence of antibodies;
Possibility of a suitable ART strategy (e.g. ICSI instead of a standard IVF procedure in a positive antibody test).