What tests to take to determine the compatibility of spouses when planning conception?

Partner compatibility - what is it?

Incompatibility of partners at conception indicates a conflict in the individual parameters of the body, which can negatively affect the attachment and subsequent gestation of the embryo. Based on this, compatibility is determined by the absence of such factors.

Compatibility analysis is necessary for those couples who do not become pregnant after regular unprotected intercourse for more than 1 year. Analysis of the compatibility of spouses is also carried out with the following factors:

• recurrent miscarriage;
• the egg is not fertilized;
• fading of fetal development.

Biological conflict of marital material is the cause of 20% of pregnancy pathologies. Doctors have identified the types and causes of possible incompatibility:

1. Blood compatibility. The Rh factor and blood group are currently not difficult to correct causes of infertility, however, serious complications can arise during the 2nd and 3rd pregnancies. A conflict may arise if the mother is Rh negative and the father is Rh positive.
2. Immunological incompatibility of spouses. When the functioning of the immune system is disrupted, both women and men can secrete antisperm antibodies. Most often, immunoglobulins are found in the mucus of the vaginal microflora; they prevent sperm from moving inside it, reduce motility and destroy it.
3. Microflora incompatibility. When the bacterial balance is disturbed, the composition of the mucus changes, which leads to impaired sperm motility and destruction of their structure, which means the impossibility of the natural process of fertilization.
4. Genetic compatibility. Every human cell contains a leukocyte antigen that protects it from dangerous agents. If the spouses have at least 2 alleles in their blood, the woman’s body will perceive the fetus as its own mutated cells and begin to attack it. Fortunately, such a biological conflict is possible only with consanguineous ties.

To understand why incompatibility between partners is possible, a number of studies should be conducted. To determine the compatibility of the Rh factors of the spouses, a general blood test is performed. To identify the presence of an immunological conflict between spouses, the Kurzrock-Miller test is intended, and a post-coital test should also be taken. To assess the state of the microflora of both partners, a smear is taken from the woman’s vagina and from the man from the urethra.

The establishment of genetic mutations is carried out through an expensive DNA test, so you should first be tested for the presence of other types of incompatibility.

Compatibility for conceiving a child

Lack of pregnancy for a long period can be observed even in couples in which the spouses are completely healthy.
This may be due to the individual compatibility of partners, or rather their biological materials. The clinic offers its patients to take a test to determine the biological compatibility of spouses. Based on the results, the reproductive specialist will offer the couple therapy or a method of reproductive technology that can help overcome incompatibility.

Why should you contact the Life Line clinic?

Many years of experience in the field of reproductive technologies and highly qualified staff of the Life Line clinic, combined with the latest medical equipment, guarantee the reliability of the results of incompatibility testing.

• An individual approach to each couple facing the problem of infertility ensures the appointment of rational diagnostic procedures and the development of an effective reproductive program.
• A team of experienced certified reproductive specialists will conduct a post-coital test, strictly observing all the subtleties of the technique used, which will ensure 100% reliability of the result.
• The clinic’s modern high-tech embryological equipment will allow you to conduct a compatibility test quickly and efficiently.

Diagnosis of immunological incompatibility and results

An immunological factor is the cause of infertility in about 10% of diagnosed cases. The aggressive reaction of the protective mechanisms of the female body is associated with the biological titers of both partners. The emergence of antisperm antibodies in girls is possible in the presence of infections, disorders of the mucous membrane, AST in a man, or unprotected anal sex.

You can find out about the presence of AST by taking a test to determine the compatibility of partners for conception. To establish an immunological conflict, the following methods are used:

1. Postcoital Shuvarsky-Sims-Guner test. A postcoital test is carried out 4-6 hours after intercourse has occurred, but the recommended sampling period is from 9 to 24 hours. For analysis, cervical mucus is taken with a sterile pipette in the gynecologist's office, and the condition of the sperm, their mobility, and the presence of antisperm antibodies are assessed during the study.
2. Kurzrock-Miller test. To carry out the analysis, sperm and cervical mucus of the spouses are collected. Compatibility is checked by combining the biomaterial in the laboratory. A laboratory assistant spends 6 hours studying the interaction of liquids using a microscope. The results of the study are deciphered only by a doctor.
3. Spermogram. Donating sperm is necessary to determine the number of sperm, their motility, morphological characteristics, number and type of leukocytes, immature sperm cells, etc. Macroscopic parameters of the biomaterial are analyzed - sperm volume, color, liquefaction time and viscosity of the ejaculate, pH.

Before performing the Kurzrock-Miller test, it is advisable to take a microflora smear for both partners, abstain from sexual intercourse for 3 days, and stop using local medications.

What is a post-coital test and what is it intended for?

When examining and observing sexual partners and not identifying any pathologies for conceiving a child, their incompatibility is suspected. To accurately establish this diagnosis, it is necessary to undergo a postcoital test—or, in other words, Shuvarsky’s test. This post-coital test is intended to establish the level of interaction of cervical mucus with sperm, since the reason for the inability to get pregnant may be a violation of their mutual compatibility. The female body can simply produce antisperm antibodies that kill sperm, so we can talk about immunological incompatibility among partners. As a rule, doctors recommend undergoing a post-coital test in the following cases: Couples who have been sexually active for more than a year without any means of contraception have been unable to conceive a child; when an official diagnosis is made - infertility; doubts about the compatibility of partners.

Is incompatibility a death sentence?

Incompatibility at conception is the cause of 20% of diagnosed cases of infertility. To make such a diagnosis, a compatibility test for conception is performed. Currently, medicine is able to overcome numerous obstacles when planning children and, depending on the cause of incompatibility, the doctor determines treatment methods for each specific couple.

Conflict of Rh blood is the most easily eliminated factor. If the wife has a negative blood type, and the husband has a positive one, then when expecting a second child, an immunoglobulin injection is administered, which reduces the quality of the woman’s body’s response to the fetus. This injection is given 2 times - at 28 weeks of pregnancy and immediately after childbirth.

It is easy to get pregnant if there is microflora incompatibility. Since the motility and number of surviving sperm depends on the state of the microflora of the genital organs, you can simply “tighten up” these indicators. If the result is negative, the doctor prescribes antibacterial, anti-inflammatory drugs and probiotics.

In case of genetic incompatibility of partners, fertilization is possible using auxiliary methods with donor material.

It is impossible to cure immunological pathology, since antibodies are the body’s memory of hostile bodies. The immunological conflict for conceiving a child can be circumvented by prolonged isolation of seminal fluid during sexual intercourse, while taking antihistamines or corticosteroids.

Reasons for prescribing the procedure

Blood compatibility for conception is established in the presence of the following factors:

• the presence of Rh conflict;
• cervical factor.

In both cases, there is an immune incompatibility of the female body with seminal fluid or fetus. In this case, the body perceives the fetus and sperm as foreign bodies. When semen enters the blood, special substances called antibodies appear in the blood. Sperm and fetus are considered antigen in both situations. When an antigen merges with an antibody, a chain is formed, which is accompanied by the death of the negative substance. This reaction is called autoimmune.

Many couples believe that if the partners are incompatible, conceiving a child is impossible. This is wrong. If you contact a specialist in a timely manner, this problem can be easily resolved. The course of the entire pregnancy with this disease is accompanied by careful monitoring by a specialist.

The test is also prescribed in cases where partners do not use contraception and pregnancy does not occur. When visiting a doctor, a thorough examination of the health of both partners is carried out. If you are in good health, two tests are prescribed.

Bottom line

Analysis of partner compatibility includes the study of the aggressive reaction of the female body to the penetration of sperm. To establish the cause of infertility, it is necessary to take into account the types of incompatibility and diagnostic methods:

1. Immunological factor - determined by passing the Kurzrock-Miller test and postcoital compatibility test.
2. Disturbance of the bacterial balance of microflora - for examination, a smear is made from the vagina and material is taken from the urethra.
3. Blood compatibility - a general blood test to determine the Rh factor.
4. Genetic factor - studied by analyzing the DNA of both partners.

After determining the cause of infertility, the doctor must prescribe treatment to correct the biomaterial or recommend auxiliary fertilization techniques. All types of incompatibility can be circumvented with the right approach.

Purpose of the method

The essence of the compatibility test is to determine the number of active sperm in the cervical mucus.

Mucus plays a huge role in pregnancy:

• is a natural barrier to the penetration of infection and male gametes into the female genital organs during the luteal (secretory) and follicular phases of the cycle, forming a plug. But during the ovulatory (proliferative) phase, a favorable environment is created for the most mobile sperm to reach the egg and fertilize it;
• provides energy nutrition to germ cells;
• promotes the selection of viable sperm without defects;
• creates a temporary “storage” for gametes, where they can linger, maintaining viability, and then gradually penetrate into the uterine cavity;
• serves as a catalyst for capacitation (ripening of male cells to the point of being able to fertilize female cells).

The cervical canal is the first obstacle overcome by sperm on the way to the egg. Cervical secretion is formed under the influence of hormones that determine viscosity and porosity. Progesterones “thicken” the fluid, estrogens make it more abundant. Half of it consists of water, the rest is glycoproteins (two-component proteins), leukocytes, and acids. By ovulation, the pores of the substance expand, it becomes less viscous. This promotes sperm movement. The current directed outward “filters” full-fledged gametes, which is necessary for a healthy pregnancy.

Mucus acquires favorable characteristics from about the 9th day of the 28-day cycle before ovulation. Attempts to conceive in the luteal phase may lead to nothing, since sperm may “get stuck” in the cervical substance and not overcome it.

Compatibility test results

The study is carried out as follows: material taken from a woman, together with a sample of male sperm, is placed on a glass slide, combined and examined under a microscope. This observation is carried out for two hours. If some of the sperm were able to penetrate the mucus, then the postcoital test is negative, that is, no antibodies to male gametes are observed. When most of the sperm die and the survivors become inactive, the Shuvarsky test is considered positive. The interpretation of the examination results is determined by the number of sperm that have entered the uterine mucus of the cervix, and the possibility of fertilization is assessed by their mobile state.

The interpretation of the test can be determined by categories: a, b, c, d—namely:

1. If the result is positive (category A), the chances of getting pregnant are very high.
2. A satisfactory result (category B) also indicates a high chance of conception.
3. A questionable result (category B) indicates poor sperm motility; perhaps the day of the test was chosen incorrectly.
4. A poor result (category D) indicates the detection of immobile sperm, which indicates poor compatibility of partners.
5. A negative result means no sperm are detected.

Factors influencing unsatisfactory results

There are several reasons that negatively affect the result:

• the reason may be an insufficient amount of sperm, that is, sperm not penetrating into the female genital tract;
• a man has a problem with ejaculation;
• frequent change of sexual partners;
• the test was not carried out on the day of ovulation;
• more than a day or less than four hours have passed since sexual intercourse;
• taking certain types of medications;
• the presence of inflammatory processes in the female genital organs;
• hormonal imbalance in a woman’s body.

The role of blood type in conception

The baby's blood is created by the fusion of maternal and paternal blood. However, initially, upon conception, he can receive absolutely any blood type. However, parental blood is a priority, and almost always the child turns out to have the blood type of the father or mother. Although this is not guaranteed, and the baby may well have a different blood type from the parent. If the blood type of the spouses matches, there is a 92-98% chance that the child will have the same blood type. Couples with the same blood type are an ideal combination for conceiving a child. But such coincidences are quite rare.

A problem conception can be called a case when the child’s mother has blood type 0, and the child himself receives the father’s blood type (A, B, AB). The mother’s body begins to produce antibodies that view the child as something foreign and try to rid the body of it. The process is similar to the conflict of Rh factors, but it is easier.

It should be noted that if the father has a higher blood type than the mother, this contributes to the birth of a healthy baby. Most often, the child receives the mother's blood type.

Emotional and psychological compatibility

When it comes to moral satisfaction with each other in life together, this is the psychological compatibility of the couple. Unresolved conflicts and problems, mutual grievances, and lack of psychological comfort disrupt harmony in family life. This depresses the psycho-emotional state, and easily vulnerable people are especially susceptible to this. Discomfort in the relationship between spouses can even manifest itself as the inability to conceive and bear a baby. It also happens that the desire to have a child becomes a “fixed idea” for spouses. The woman becomes fixated, nervous and cannot get pregnant. In practice, it happens that a couple, desperate to conceive a child, adopts a baby, and after some time they have their own. The woman calms down, they stop waiting, and eventually a miracle happens - she becomes pregnant.

Pheromones

The compatibility of partners can be influenced by pheromones, the production of which is responsible for white cells. Pheromones determine the unique smell of a person. This means that a person may not want to have a child with his partner on a subconscious level, despite the fact that the relationship may be passionate and tender.

Determinant of compatibility - Rh factor

Rh factor is a protein that lives on the surface of human red blood cells. This is a hereditary factor that is absolutely unchanged. Owners of this protein (and approximately 85 percent of the entire population) have a positive Rh factor. Those who lack protein are Rh negative. Couples who have identical Rh factors (either positive or negative), or in the case where the woman has a positive Rh factor and the man has a negative Rh factor, are compatible for conception.

But what to do if a woman with negative Rh and a man with positive meet? Then, upon conception, the embryo begins to conflict with the mother’s body if the child receives the Rh factor from the father. The tiny red cells end up in the mother's blood, causing her immune system to create killer cells (antibodies) that begin to attack the fetus. As a result, if certain measures are not taken, everything can end very badly: serious illness of the fetus and newborn, death of the baby inside the womb, spontaneous miscarriage.

When planning to become pregnant, a woman who has a negative Rh factor must find out what level of antibodies is in her blood. When pregnancy occurs and until its end, from the seventh week onwards, she must check the level of antibodies every month. The doctor should monitor the size of the child's liver. An enlarged liver is an indication for intrauterine blood transfusion. Which in turn can pose a threat to pregnancy.

After the baby is born, during the first three days after birth, the mother is administered anti-Rhesus immunoglobulin so that antibodies do not appear in the body as a result of the baby’s blood during childbirth.

Spouses who are incompatible by Rh factor do not need to fall into despair. There are various preventive measures in medicine that make it possible to conceive and bear a baby, as well as to promptly identify and treat the suspected hemolytic disease of the child.