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Sperm Invasion Test

When is a sperm invasion test recommended

The sperm cannot wait to escape from the acidic environment of the vagina to the more friendly alkaline surroundings of the cervical mucus. If your mucus is apparently normal in quantity and "stretchability" and your husband's semen analysis is known to be normal, one would expect to find an active and progressively motile sperm population in the mucus at post-coital testing. If after repeated post-coital testing the sperm are always absent or always dead or only shaking on the spot instead of progressively moving, this indicates a need for further investigation.

It is obviously important to determine from you both that intercourse is completely satisfactory and that ejaculation is taking place within the vagina. Certain lubricants such as K-Y jelly act as a spermicide, and therefore should not be used by infertile couples.

What is the sperm invasion test

A special test known as a sperm invasion test allows the specialist to see for himself whether or not your husband's sperm can penetrate and survive in your mucus. It also gives him the chance to perform a microscopic examination of your husband's semen and compare this with the laboratory report. 

How is the test carried out

You are asked to come to the clinic at the expected time of ovulation but you must have abstained from intercourse in the preceding 24 hours. The procedure is then very similar to the post- coital test in that a mucus sample is withdrawn from the canal of the cervix. 

The mucus extracted from the canal of the cervix is placed onto a glass slide.  A drop of semen from a fresh sample that your husband has produced in the previous hour is then placed next to it, so that the surfaces of the mucus and semen are in contact with each other. (The remainder of the semen sample is not wasted but introduced artificially into the canal of the cervix).

The slide is now examined under a microscope. The sperm activity is assessed over the next quarter of an hour. Initially the ability of the sperm to penetrate into the mucus will be observed. Then the specialist will study whether or not sperm motility is maintained after mucus penetration. 

What are the negative indications of this test

If sperm penetration does not occur or if sperm motility is not maintained in the mucus, there is then some form of antibody interacting between sperm and mucus. Antibodies in the sperm can inhibit the movement of the sperm. If these antibodies are present in the mucus, sperm motility will rapidly diminish and eventually stop.  If there are antibodies in the semen sample, the specialist will observe areas of sperm clumps throughout the sample instead of there only being freely motile sperm. A clumping or agglutinating antibody is responsible for sticking the sperm to each other. Tests done on blood samples from you and your husband can also indicate whether these antibodies are present.

What is the "cross-over sperm invasion" test

A "cross-over sperm invasion test" is more specific in that it can help in determining whether the negative post-coital test is due to some antibody or other factor in your mucus or in your husband's sperm.  While conducting this test, the specialist will observe the ability of known normal donor sperm to penetrate your mucus and the ability of your husband's sperm to penetrate and survive in known normal donor mucus. 

How are the investigations conducted

An ejaculation is made up of several components. In 90% of patients, the first part of the ejaculate is made up of most of the sperm and fluid from the prostate gland.  The remainder of the ejaculate is seminal fluid from the seminal vesicles and has a low sperm content. When the volume of seminal fluid is high, the sperm count per ml may be very diluted. A semen analysis of the first part of the ejaculate should reveal a sperm count much higher than for the normal total semen sample.

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