Sperm Agglutination

Reviewed by Dr. Oreoluwa Ogunyemi, UrologistCheckmark | Last updated: April 7, 2020

What Does Sperm Agglutination Mean?

Sperm agglutination refers to sperm clumped together. It is usually measured as a percentage of the total number of sperm in a sample. When sperm agglutinate, they cannot swim properly and cannot fertilize an egg. Therefore, sperm agglutination can cause fertility issues in men.


FertilitySmarts Explains Sperm Agglutination

A typical sperm analysis will measure:

  • The number of sperm
  • The motility (movement)
  • The morphology (shape)
  • The agglutination (sticking together) of sperm

The results of this test will categorize sperm agglutination by the number of sperm cells stuck together in a group, called an agglutinate.

Sperm Agglutination Classification

The grading system is as follows:

  • Grade 0: no agglutination
  • Grade 1, Isolated: <10 sperm cells per agglutinate
  • Grade 2, Moderate: 10–50 sperm cells per agglutinate
  • Grade 3, Strong: > 50 sperm cells
  • Grade 4, Complete: completely agglutinated spermatozoa

What causes agglutination?

While sperm agglutination is thought to be related to the presence of anti-sperm antibodies, other causes include genital trauma (including surgeries), infections and Vitamin C deficiency.

Some types of anti-sperm antibodies will cause the sperm to stick together in huge clumps, preventing them from moving through the cervix and uterus.

Treatment Options

Agglutinated sperm can be washed in a laboratory setting and then introduced into a uterus in a process known as intrauterine insemination (IUI).

If this is unsuccessful in producing a pregnancy, in vitro fertilization (IVF) with intracytoplasmic sperm injection (ICSI) may be used to fertilize an egg.


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