Muva nje, ukunakekelwa okunye kuye kwakhokhwa kubesilisa abangenalutho. Ngemva kokucwaninga kwabaningi abacwaningi kwacaca ukuthi isizathu salokhu yi-anti-antibodies ye-antisperm, eyakhiwa emadodeni emasendeni nasezintweni zazo. Kodwa umphumela owodwa we-spermogram akwanele ukudalula ngokuphelele imbangela yokungasebenzi. Ngakho-ke, ukuze kutholakale ukuxilongwa okunembile, odokotela banikeza isincomo sokuhlaziywa kwesinye semvu - ukuhlolwa kwe-MAR ("ukuxubana kwe-agglutination reaction", okusho ngokwezwi nezwi ukuthi "ukuxubana kwamagciwane").
Ama-antigens kuleli cala yizinambuzane ku-spermatozoa. Uma bengenakukwazi ukubhekana nama-antibodies antisperm, khona-ke i-spermatozoon ihlanganiswe nebhubhiso le-antispermic elivimbela ukunyakaza kwalo.
Ukuhlolwa kwe-MAR kwenza kube lula ukuthola lezi zinqamuzana noma ziqinisekise ukungabikho kwazo.
I-spermogram evamile ayivumeli ukudalula lesi sifo, ngoba kulokhu kuhlaziywa, i-spermatozoon, eyonakaliswa ama-antibodies antisperm, ibonakala evamile. Kodwa ngesikhathi esifanayo, akakwazi ukutshala iqanda futhi empeleni ayilungile. Ukuhlolwa kwe-MAR kwenza kube lula ukunquma isilinganiso se-spermatozoa esonakaliswe ngamagciwane, kubuningi obuphelele obukhishwe ku-ejaculate eyodwa. Futhi nguye kuphela okwazi ukukhombisa inani eliqondile le-spermatozoa enempilo ekwazi ukubamba iqhaza kwinqubo yokukhulelwa. Uma imiphumela ye-MAR-yokuhlolwa ingalungile, okusho inani elivumelekile lamagciwane, khona-ke ezinye izimbangela zokungazalwa emadodeni zifunwa.
Izimbangela zokubonakala kwama-antisperm antibodies emzimbeni wesilisa
Eqinisweni, izizathu ezenza umzimba womuntu uqale ukulwa namaseli akhe aphilile ngandlela-thile:
- ukwamukelwa kwezinambuzane zezitho zangasese (kufaka phakathi ukungenelela kokuhlinzwa);
- ukwephulwa kwesivinini esiphakathi kwemithambo yegazi kanye nemigodi yamanzi;
- ukutholakala kwezifo;
- isifo se-urogenital system;
- kunezizathu zokusuka okungacacile;
- ukulala ngokocansi (ukutholakala kwamaprotheni angaphandle kubonakala sengathi umzimba uyisongo).
Izinkomba ngenjongo yokuhlolwa kwe-MAR
Isivivinyo sokunquma ukutholakala noma ukungabikho kwe-antisperm antibodies kunqunywe uma kwenzeka kutholakala ku-spermogram ye-pathologies ye-spermatozoa njenge:
- ukuhlukunyezwa;
- i-aggregation;
- ukwehla ukuhamba;
- ukungabi khona isikhathi eside kokukhulelwa kumbhangqwana oshadile;
- ukulungiselela i- IVF ne- ICSI .
Uma udokotela eqoke lokhu kuhlaziywa, kungaba ngcono ukuthatha uhlolo lwe-MAR ku-laboratory yezobuchwepheshe obuphezulu, ngoba imishini ehamba phambili kakhulu isetshenziselwa ukucubungula izinto zokuhlaziywa, okuthinta ngokuqondile ukuchithwa kohlaziyo olubiza kakhulu.
I-MAR-ukuhlolwa kwama-antibodies antisperm kusikisela ukutholakala kwabo hhayi kuphela ekuhlolweni kwesidoda, kodwa nasekuhlaziyweni kwe-serum. Ukumisa ukuhlolwa kwe-MAR:
- I-MAR-test evamile - uma imiphumela yokuhlaziywa engabonakali i-spermatozoa eyonakaliswe ama-antibodies antisperm.
- Ukuhlolwa kwe-MAR-negative kusho ukuthi inani le-spermatozoa elonakalisiwe alikho ngaphezu kwe-50%. Le nkhomba ingabuye ibhekwe njengokujwayelekile.
- Ukuhlolwa kwe-MAR kulungile, kucatshangwa lapho ukuhlaziywa kubonisa ukuthi inani le-spermatozoa egoboleni le-antispermic lingaphezu kwama-50%. Lesi sibonakaliso sikhombisa ukuthi kungenzeka ukuthi umuntu angakwazi ukukhulelwa ngamagciwane.
Uma ukuhlolwa kuka-MAR kubonisa umphumela omuhle we-100%, ukukhulelwa kwemvelo kwendoda ehlolwe kungenakwenzeka. Kulokhu, odokotela basikisela ukusebenzisa indlela yokukhulelwa nge-IVF ne-ICSI.