Contents
- What is male infertility?
- What is the HBA test?
- Why is the HBA test performed?
- What is the role of hyaluronan in the fertilization process?
- What are the indications for an HBA test?
- What are the limitations of performing the HBA test?
- How should I prepare for the HBA test?
- How is the HBA test performed?
- How are HBA results analyzed?
- How much does the HBA test cost?
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Male infertility accounts for about half of the problems conceiving a child. There are many diagnostic tests that allow you to find out the cause of the problem. One of the tests is the HBA test, which is a functional test that allows you to determine the maturity of sperm in a sample of fresh sperm. What is the HBA test and when should it be performed?
What is male infertility?
Male infertility is a problem for almost half of the couples who treat. Today it is considered a disease and its causes can be many. The causes of male infertility include, inter alia, testicular cancer, abnormal testicular development, congenital absence of one or both.
Infertility can also be the result of inflammation of the prostate gland, testicles and epididymis. Fertility disorders can also be caused by phimosis, hypospadias, congenital lack of vas deferens, varicose veins and many other diseases and defects in the structure of the male reproductive system.
What is the HBA test?
The HBA test is a functional test that is performed as an extension of the diagnosis. Thanks to it, it is possible to choose the appropriate method of supporting reproduction, and thus gives a better chance for a couple to conceive a child. The purpose of this test is to determine the ability of sperm to bind to hyaluronic acid, which makes it possible to determine the number of mature sperm capable of fertilizing the egg.
Why is the HBA test performed?
The HBA test is designed to determine the maturity of sperm in a fresh sperm sample. The test is based on the ability of mature sperm to bind to hyaluronan, i.e. hyaluronic acid. The name of the test comes from the English name hyaluronian binding assay, i.e. the hyaluronan binding test.
Check: Testicular biopsy and diagnosis of male infertility
What is the role of hyaluronan in the fertilization process?
Hyaluronan plays a vital role in the interaction between the sperm and the egg. Proper course of these interactions leads to fertilization. Hyaluronan occurs naturally in the intercellular matrix of the cumulus ovary that surrounds the egg. It is secreted in large amounts by the granular cells of the cumulus.
In the final stages of sperm maturation, special places are formed on the surface of their heads, which are intended to bind to hyaluronan and the ovum’s cover. They are necessary for this process to take place and, consequently, for fertilization in the woman’s genital tract.
The ability of sperm to bind to hyaluronan is necessary for the fertilization of the egg!
If these surfaces are not developed, the sperm are unable to bind to the hyaluronan and thus to fuse with the surface of the ovum’s sheath. It is not possible both in natural conditions and in the process of in vitro fertilization by IVF. The inability to bind to hyaluronan means that the egg cannot be fertilized.
What are the indications for an HBA test?
The indications for the HBA test are:
- extended sperm testing showing little or no abnormalities;
- the need to perform additional diagnostic tests to complete the diagnosis of male infertility;
- recurrent miscarriages;
- abnormal results in the SCD and MSOME tests (a large number of sperm with DNA fragmentation or a high percentage of abnormalities in sperm morphology);
- idiopathic infertility, i.e. of unknown cause (when other parameters are normal);
- qualification of a pair for assisted reproduction methods (eg ICSI).
Check: Infertility treatment methods
What are the limitations of performing the HBA test?
A prerequisite for the HBA test is the presence of motile sperm in the fresh semen. Therefore, it is not possible to perform the HBA test in patients with known severe asthenospermia, i.e. a severe reduction in sperm movement in the semen, and necrospermia, which means that all sperm are stationary and therefore dead.
How should I prepare for the HBA test?
There is no need to prepare yourself for the HBA test. In order to perform it, first of all, a semen sample donated by the patient is necessary in accordance with the rules that apply when donating semen for other tests.
The most important thing is to abstain from intercourse for several days. It is also worth giving up alcohol and other stimulants at least 5 days before giving the sample back.
Check: Andrology and male infertility
How is the HBA test performed?
The HBA test is performed on a microscope slide that is coated with hyaluronic acid. A sample of fresh semen is placed on the slide prepared in this way. After several minutes, the sample prepared in this way is viewed under a light microscope. In this way, at least 100 motile and non-bound sperm cells are counted. This makes it possible to calculate the percentage of sperm that bind to hyaluronan in the test sample.
How are HBA results analyzed?
The result is interpreted on the basis of the reference values given on the test result, which is set by the manufacturer. If the test shows a high percentage of sperm that is not bound to hyaluronan, it means that the male sperm has no possibility or has a limited ability to fertilize the egg. In addition, the use of such sperm during IVF can lead to non-fertilization.
The test is also performed during the qualification of patients for in vitro fertilization in order to select the appropriate method of fertilization of the ova.
The HBA test result is considered normal if at least 80% of the motile sperm in the test sample is bound to hyaluronan. If the quantity is less, the result is considered incorrect. However, it is worth remembering that an incorrect result does not mean infertility. A low score only indicates problems with conception, and the lower it is, the less chance the couple has of conceiving a child.
If the test result is negative, it means that the sample under the microscope shows free-swimming sperm and not adhering to the slide with hyaluronan.
However, if the test result is positive, under the microscope we will see sperm mostly attached to the slide, and few sperm should swim freely. Importantly, the sperm heads should be ‘glued’ to the slide, but their twigs should be moving.
How much does the HBA test cost?
The HBA test costs about PLN 250, and the result is available after about 2 hours.
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