Analysis of the compatibility of partners for conception: indications, preparation, methodology

December 21, 2018

Infertility treatment is not always expensive and takes many years. In 30% of cases, traditional clinical studies help to understand and eliminate the cause. One of them is an analysis of the compatibility of spouses (post-coital test and a similar in vitro study). At the Scandinavia AVA-PETER clinic you can do all types of diagnostics on any convenient day and get the most detailed and accurate results.

When is a marital compatibility analysis needed?

Compatibility analysis is the first thing that is used to determine the cause of difficulties with conception if the couple does not have obvious problems. It helps to determine what prevents the sperm from reaching a mature egg: slowness, increased viscosity of cervical mucus, an aggressive environment caused by the chemical composition of the mucus. The study will provide 100% information on further actions: whether the man needs a spermogram, whether the woman needs hormonal therapy or other treatment.

Analysis of spouse compatibility: when is it needed?

The doctor can prescribe the specified study for couples:

• who, after 12 months of active sexual activity and not taking contraceptives, have not conceived;
• with an established diagnosis of infertility;
• having a possible violation of “sexual incompatibility”.

Thanks to the study, it is possible to understand 100% what to do next, whether the man should undergo a spermogram, whether the woman needs hormone therapy or whether other methods will be required to eliminate the disorder.

What is assessed during the analysis

Shuvarsky's test makes it possible to:

1. Assess the condition of the cervical mucus. The higher the viscosity, the more difficult it is for sperm to “get” into the egg. The composition changes regularly, it is individual for each woman. For some, the mucus becomes liquid already on the 9th day, for other women the opportunity to become pregnant appears only for 2-3 days during the entire cycle.
2. To study the interaction of sperm and cervical mucus in women.
3. Determine pH in the cervical canal. This indicator is important because it affects sperm motility. Activity increases in an alkaline environment, and in an acidic environment (below 7) the movement slows down, up to complete immobilization. The optimal indicator is 7.0-8.0.

What you need to know before the study

The doctor takes a sample of cervical mucus 4-8 hours after unprotected intercourse. The laboratory analyzes the quantitative and qualitative composition of sperm, as well as their behavior in cervical mucus. For the study to be effective, follow the rules listed below:

• The day before, it is recommended to abstain from sexual activity for three days. You should not take a bath before sexual intercourse, but you can take a shower.
• It is very important to do a compatibility test during ovulation. Even with a stable cycle, it is recommended to use an ovulation test or measure your basal temperature.
• It is more effective to do two or three postcoital tests over several cycles in a row, and then compare the results.

Why do you need a genetic analysis to determine the compatibility of spouses?

18.11.2014

Sometimes perfectly healthy married couples cannot have children for a long time. Moreover, there are no visible causes of infertility, but the long-awaited pregnancy never occurs. Although in some cases it occurs, miscarriage occurs in the early stages. The reason for this is the genetic compatibility of the partners.

What is compatibility?

Approximately 6% of miscarriages or non-pregnancies are due to immunological infertility. In other words, two people are incompatible with each other, while antibodies to sperm are formed in the female body, and as a result they simply die.

Of course, in this situation, pregnancy will not occur, but if this happens, then the fetus that received a set of chromosomes from a man will also turn out to be foreign and will die within three weeks. Nowadays, we haven’t figured out exactly why this happens, but we already know what can lead to this:

• Surgeries on the ovaries or uterus
• Scraping
• Presence of an intrauterine device

The male body may also have antibodies to its sperm. This can be detected if, during the analysis process, spermatozoa that are inactive and linked to each other are visible under the microscope. In addition, it is believed that their occurrence can be triggered by surgery, trauma to the scrotum and high temperature.

Why does miscarriage happen with genetic compatibility?

As you know, when a baby inherits histocompatibility antigens, he takes half from his father and the same amount from his mother. In this case, the antigens must be completely different. The maternal body reacts to pregnancy and launches an immunological process to preserve it.

The cells of the fetus are perceived as foreign, but the female body does not touch them, since protective antibodies for the fetus are produced. This is why HLA antigen compatibility is important to carry a child to term.

But when the antigens of a man and a woman coincide, the mother’s body assimilates the pregnancy as its own cells. Accordingly, no immunological reaction occurs to protect the infant. The fetus is attacked by the female immune system. This is what causes miscarriage and miscarriage.

Genetic compatibility examination

As a rule, the genetic compatibility of spouses does not pose a danger to future children, since the main problem is the inability to bear and become pregnant.

In addition, similar genes in parents in some cases lead to abnormalities in the development of the infant. Therefore, it is better to do not only a compatibility test, but also a detailed blood test.

Test results are usually released after a few weeks. Parents first donate venous blood for analysis. Using special reagents, pure DNA is isolated, and each gene is examined. Then only comparative diagnostics is carried out.

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How can a compatibility test help you conceive?

Two real-life examples of how simple analysis eliminated expensive research. After long periods of infertility, couples became pregnant naturally.

Postcoital test revealed ASAT

The couple has already been tested for sexually transmitted infections (all tests are negative), the husband had a spermogram with excellent results, and there has been no pregnancy for a year or more. A post-coital test helped determine that sperm that are motile in normal life, once they enter the cervical canal, become sluggish, and after a few hours their membranes begin to collapse. A woman's blood test revealed a high level of antisperm antibodies. After six months of hormone therapy, the couple was able to conceive naturally.

Compatibility analysis helped correct the cycle

When sperm entered the cervical mucus, they lost their motility, but ASAT was not detected in the woman’s blood. After two repeated tests, it turned out that the time of ovulation in the cycle was shifted closer to its beginning. Both the compatibility test and attempts at conception took place during a period when the mucus density naturally increased to protect the reproductive system. Correcting the menstrual cycle helped conceive on the first try.

HLA typing analysis

To detect leukocyte incompatibility, blood is taken from both partners and examined for the presence of HLA complexes. During screening, the HLA phenotype of each spouse is determined and a comparative analysis is carried out.

Detection of leukocyte infertility requires long-term treatment. Medicines to suppress the activity of leukocyte antigens and lymphocytes will help improve the susceptibility of partners' genes. They remove barriers to pregnancy, facilitate pregnancy, and prevent the development of intrauterine anomalies.

Indications

Blood screening is prescribed if spouses are unable to become pregnant or if recurrent miscarriage is diagnosed. Another reason for HLA compatibility analysis is frequently repeated (2 or more) failures during in vitro fertilization.

In some cases, only the spouse’s blood is examined, since certain antigens negatively affect spermatogenesis. Pregnancy does not occur or the risk of developing intrauterine anomalies is high.

Preparation

No special preparation is required for the analysis. It is enough to follow the general recommendations for donating blood:

• two days before sampling, stop using medications unless there are vital indications for taking them;
• Avoid alcohol consumption and smoking within 48 hours;
• 8 hours before the test, do not eat.

If you cannot refuse food due to health problems, then you need to inform your doctor, who will decipher the data.

Carrying out

Blood sampling for hla-compatibility analysis is performed from the ulnar vein. The doctor asks you to bend your arm at the elbow and applies a tourniquet. After filling the syringe, he treats the puncture site with an antiseptic and bandages it.

Leukocytes are separated from the biomaterial using a centrifuge. Then, using the polymerase chain reaction (PCR), the concentration of a certain nucleic acid fragment is increased to a quantity sufficient for visual detection (detection).

The analysis can be carried out by two methods: serological and molecular genetic. When carrying out the first, antigens are studied, the second - the DNA chain that creates them.

Analysis readiness time and accuracy

For this test there are no concepts of “pathology” and “norm”. Immunological incompatibility of husband and wife based on HLA class genes can be diagnosed if four or more matches out of six possible are identified.

The results of the analysis are interpreted as follows:

• partial incompatibility indicates a genetic predisposition to miscarriage;
• complete incompatibility (4 or more matches) means that it is unlikely to become pregnant without medical help.

Don't rely too much on the results of the analysis. The processes of autoimmune regulation of conception are complex and not fully understood. Some modern experts do not even recognize the role of HLA antigens in a woman’s inability to become pregnant.

In addition to the HLA system, there are many other factors that cause failure to conceive: thrombophilia, chromosomal abnormalities, large amounts of homocysteine ​​in the blood (hyperhomocysteinemia). Therefore, it is wrong to attribute all problems solely to the HLA phenotype.

You can take a compatibility test on the direction of a doctor or on your own initiative. The screening turnaround time in most clinics is 7 days.

average price

The price of HLA compatibility typing varies among laboratories. When studying spouses, it doubles.

Table: average cost of HLA compatibility analysis, Moscow and Yekaterinburg:

The cost of blood sampling must be added to the price of the analysis. In different laboratories it ranges from 150 to 220 rubles for one person.

If spouses fail to become parents for a long time, it is wiser to undergo a full examination. HLA typing analysis is quite specific and is rarely prescribed, since the cause of the inability to get pregnant can be determined by other, more accurate methods.

But gynecologists recommend performing postcoital testing when planning pregnancy. With the help of screening, it is often possible to identify a disease in one of the parents that leads to infertility. After his treatment, nothing interferes with the successful conception and bearing of a baby, even if it has not been possible to get pregnant for several years.

Photo: ru.freepik.com, yandex.ru

Why exactly to “Scandinavia AVA-PETER”?

The postcoital test does not require sophisticated equipment and can be done in any medical center. But at the Scandinavia AVA-PETER reproductive medicine clinic, you are guaranteed correct interpretation of the study results and effective treatment after the first analysis. In addition, we have:

• you can do any other tests to determine the causes of infertility;
• get advice from a fertility specialist with many years of experience;
• undergo a course of treatment using any of the existing infertility treatment methods.

Make an appointment with a doctor on the website or call.

Postcoital test: what is it?

A postcoital test is a study of mucus taken from a woman’s cervical canal 4–9 hours after intimacy.

The analysis allows you to assess the condition of the mucus and study its interaction with sperm, namely the ability of male germ cells to penetrate through the cervical mucus in order to reach the egg and fertilize it.

For example, the mucus may be too thick. In this case, the sperm will not be able to move in it and will not reach the egg. In addition, the mucus may contain anti-sperm antibodies or too many white blood cells, which block the movement of sperm.