Spermogram and MAR-test: detailed notice for the patient

Introduction The spermogram is the main tool for assessing male fertility. Male reproductive cells are extremely sensitive to external influences: stress, overheating, medication intake, or even a glass of wine can temporarily significantly deteriorate the results.

In order for the doctor to get a true idea of your health status, and not the consequences of random factors, it is essential to follow preparation guidelines. Please take this seriously: preparation begins several days before the clinic visit.

1. Abstinence: “the right middle ground”

It is one of the most important points influencing the accuracy of the result. The duration of sexual abstinence (excluding all forms of ejaculation) should be as follows:

• Minimum: 48 hours (2 days).
• Maximum: 7 days.
• Optimal: 3 to 4 days.

Why is this important?

• If abstinence is less than 2 days: the semen volume may be insufficient and sperm concentration artificially underestimated.
• If abstinence is more than 7 days: sperm will accumulate in large quantities, but they will be “old,” with low mobility and a high number of defects.

Important for a new test: if you are repeating the test (to monitor treatment progress), try to follow exactly the same number of days of abstinence as the first time.

2. “Black list”: what to avoid before analysis

7 to 10 days (and ideally 2 weeks) before the analysis, eliminate factors that inhibit sperm production:

Temperature (critical!)

Overheating is deadly for sperm.

• Strictly forbidden: baths, saunas, hot baths (take only lukewarm showers).
• To avoid: seat heating in the car. Use it as little as possible or turn it off as soon as the interior warms up.

Toxins and medications

• Alcohol: total abstinence for at least 7 days. Even low-alcohol drinks (beer) alter the shape of sperm.
• Medications:
  • Antibiotics: the test cannot be performed before 14 to 30 days after finishing treatment (consult your doctor for the exact duration).
  • Sedatives and sleeping pills: can reduce sperm motility.
• Smoking: try to reduce your cigarette consumption as much as possible.

Physical activity and sleep

The day before the sample, avoid intense physical efforts, exhausting sports training, and significant emotional stress. Try to sleep well before the analysis.

3. Collection rules

Where to collect? The “gold standard” is to collect directly at the clinic, in a specially equipped room.

• Why is this important? Sperm start losing their motility immediately after ejaculation. When collected at the clinic, the sample is processed instantly, ensuring 100% accuracy of the results.
• Home collection: only allowed in exceptional cases (with the doctor's approval). The container must be transported to the laboratory at room temperature (close to the body, under the jacket) within 30 to 40 minutes. For the MAR test, home collection is strongly discouraged.

Collection technique:

1. Container: use only a sterile container provided by the clinic or purchased at the pharmacy. Do not touch the inside of the container or the lid with your fingers.
2. Hygiene: before collection, wash your hands and genital area thoroughly with soap, rinse abundantly with water, and dry with a clean towel.
3. Restrictions:
   • Do not use creams, Vaseline, lubricants, or saliva (these substances are toxic to sperm).
   • The sample must be obtained solely by masturbation.
   • Avoid using a condom (the lubricant kills sperm).
   • Intercourse interruption is not suitable (risk of contamination by vaginal epithelial cells and loss of the first portion).
4. Total sample: it is essential to collect all of the ejaculate, especially the first portion (which contains the highest concentration of sperm).
   • Emergency situation: if part of the sample is lost (spilled), be sure to inform the lab technician or doctor when you return the container. There is no shame in this, but it is essential for accurately calculating the indicators.

4. Spermogram + MAR test

These two examinations are often performed simultaneously from a single sample of biological material.

• What is it: the MAR test (Mixt Agglutination Reaction Test) detects an immunological factor of infertility: the presence of anti-sperm antibody antibodies, which occur when the immune system attacks sperm, depriving them of the ability to fertilize.
• Preparation: The preparation rules for the MAR test are identical to those of a standard spermogram. No additional measures are needed.

5. Checklist before leaving home

Check the following points before heading to the clinic:

• You have followed abstinence for 3 to 4 days.
• I have not consumed alcohol and have not been to the bath/sauna in the last 7 days.
• I have not taken antibiotics in the past month.
• I have my passport with me (to fill out documents at reception).
• I feel well (no fever, cold symptoms, or worsening of chronic illnesses – in these cases, it is better to postpone the analysis).