精子DNA损伤与辅助生殖技术

Sperm DNA Damage and Assisted Reproductive Technology

随着辅助生殖技术的广泛开展,精子评估已由传统的精液常规分析向细胞、分子水平深入发展。精子DNA损伤是反映男性生育力的一个新指标。精子DNA损伤的发生机制包括精子染色质包装与分离异常、氧化应激、细胞凋亡异常等。精子染色质结构分析是目前检测精子DNA损伤最常用的方法之一。精子DNA损伤可能与辅助生殖技术治疗结局、复发性自然流产、增加ICSI后代遗传风险相关。采取口服抗氧化药物、取睾丸精子行ICSI、预冻存精子、去除病因以及中医中药等治疗对策可能会降低精子DNA损伤程度,进而提高辅助生殖技术成功率。本文主要就精子DNA损伤的机制与检测方法、DNA损伤与生殖结局以及辅助生殖技术中与DNA损伤相关的治疗对策作一综述。

With the introduction of assisted reproductive technology （ART）, sperm assessment has developed progressively, from conventional semen routine tests to novel cellular and molecular measures. Sperm DNA damage is a new marker of male fertility, whose genetic mechanism involves abnormal package and segregation of chromatin, oxidative stress, abnormal cell apoptosis, etc. Sperm chromatin structure assay （SCSA） is one of the common techniques to measure sperm DNA damage. Sperm DNA damage might be associated with the pregnancy outcome of ART, recurrent spontaneous abortion and potential genetic risk of ICSI offspring. Some treatment strategies might reduce the percentage of sperm DNA damage and increase the success rate of ART, including oral administration of antioxygen drugs, ICSI with testis sperm, sperm freezing and preservation, removing of etiological factors, traditional Chinese medicine, and so on. This review focuses on the mechanism and detection of sperm DNA damage, its association with reproductive outcomes, andrelevant treatment strategies in assisted reproductive technology.