Lotti F, et al. - Experts gauged a correlation between mixed antiglobulin reaction (MAR) test positivity and clinical features or genital tract ultrasound (US) parameter values in males of infertile and fertile couples. Findings suggested an association of MAR test positivity with clinical and US features in males of infertile and fertile couples, suggestive of chronic epididymal inflammation.

Methods

• In this cross-sectional analysis, experts included 109 fertile men and 699 consecutive subjects seeking medical care for couple infertility from September 2012 to September 2017.
• A complete physical, endocrine, scrotal and transrectal US evaluation and semen analysis (including sIL-8) on the same day was done in all subjects in the authors' outpatient clinic.
• An assessable MAR test was seen in 181 of the 699 males of infertile couples (age 38.6 ± 6.6 years), whereas the test was assessable in all 109 fertile men (age 36.6 ± 5.2 years).
• Experts gauged the associations among MAR test positivity and the other studied parameters on a caseload of 290 men (patients + fertile men) and in the two cohorts of males of infertile and fertile couples.

Results

• As per data, out of the 181 men of infertile couples studied, a positive MAR test was seen in 20 (11%), including 12 (6.6%) who had a MAR test ≥ 50%, which is considered as a pathological threshold according to the WHO.
• Findings suggested that out of the 109 fertile men, four (3.7%) had a positive MAR test, of which one (0.9%) had a MAR test ≥ 50%.
• Therefore, MAR test positivity was found more often in men of infertile couples (P < 0.05).
• Results demonstrated that in the entire caseload (n=290) of males of both infertile and fertile couples, no associations between MAR test positivity and seminal characteristics were observed.
• Researchers noted an association of a positive MAR test with epididymal US abnormalities, particularly with the mean size of the epididymal body and tail (both P < 0.0001), and in infertile men, a positive MAR test was also associated with an abnormal epididymal echotexture.
• Moreover, a history of epididymitis and high sIL-8 levels was demonstrated more frequently by subjects with a positive MAR test.
• They found that considering endocrine parameters, even after adjusting for age and life-style factors (adj. r=0.232, P < 0.0001), only a positive correlation between MAR test positivity and LH levels was observed, while no associations with testosterone and FSH levels were found.