Ultimo aggiornamento 2021-11-16 15:49:26
TEST DI PENETRAZIONE DEGLI SPERMATOZOI: Sperm Penetration Test
Il test di penetrazione spermatozoo-muco in vitro (SMPT) è un test di funzionalità dello sperma che misura la capacità dello sperma di penetrare il muco cervicale e raggiungere le salpingi: dove nel terzo medio incontrano l’ovocita maturo in fase M2 e fecondarlo.
- il Test di penetrazione nel muco cervicale saggia la capacità degli spermatozoi a penetrare e conservare la propria motilità
- Se si nota, in vitro, un movimento shaking degli spermatozoi si ipotizza la presenza di auto-anticorpi (ASA) diretti verso gli spermatozoi . Il test deve essere completato dal MAR test e dall’IBT.
- quando il PCT post coital test ha dimostrato che gli spermatozoi si fermano a contatto col muco cervicale o mostrano fenomeni di shaking.
la donna deve essere in periodo ovulatorio
controllo dell’LH
FERN test (felcizzazione del muco cervicale = dimostra una maturità del muco in periodo ovulatorio, rendendo il muco penetrabile agli spermatozoi e rendendo possibile la loro capacitazione in vivo)
Muco cervicale: raccolta del muco cervicale in periodo periovulatorio (FERN test positivo) tramite una cannula sottile (aspiglaire).
Uomo: raccolta del liquido seminale dopo il prelievo del muco cervicale
è necessario un campione seminale dopo 2-5 gg di astinenza
In laboratorio:
TEST DIRETTO: al muco cervicale strisciato sottilmente su un vetrino si aggiunge qualche microlitro di liquido seminale ben omogeneizzato. Dopo circa 90 minuti si osserva se lo sperma è riuscito a penetrare nel muco cervicale e a quale distanza. Inoltre si osserva se ci sono fenomeni di “shaking” (gli spermatozoi sono incapaci di progredire, mantengono ferma la testa mentre la coda si muove freneticamente).
Noi effettuiamo il test utilizzando un capillare rettangolare millimetrato la cui estremità inferiore è immersa in una provetta in cui sono posti 50 μl di seme ed altrettanti di medium di coltura (v. disegno sottostante).
TEST CROCIATO: può essere fatto anche un test crociato usando muco cervicale di donatrice e spermatozoi del paziente, oppure muco cervicale della partner e liquido seminale da donatore. Tale test permette di vedere se fenomeni di shaking sono dovuti ad autoanticorpi del paziente o della partner.
RISULTATI
TEST DIRETTO: Normalmente gli spermatozoi penetrano il muco cervicale e si muovono in esso con motilità progressiva.
TEST DIRETTO ANORMALE: Gli spermatozoi non riescono a penetrare il muco cervicale o se lo penetrano si arrestano o si muovono con movimento shaking, o talvolta formano agglutinati specialmente testa-testa. Ciò dimostra la presenza di anticorpi antispermatozoo, che possono essere presenti nel muco cervicale o sugli spermatozoi. Una indagine accurata sul liquido seminale può dimostrare la presenza di anticorpi antispermatozoo. (MAR TEST, IBT TEST)
TEST CROCIATO:
-gli spermatozoi di donatore penetrano nel muco cervicale ma non quelli del partner maschile (patologia spermatica del partner maschile)
-gli spermatozoi del partner e del donatore non riescono a penetrare nl muco cervicale della partner.(patologia del muco cervicale della paziente).
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