人类精子形态学评估:理想形态,异常精子描述和生物识别

Assessing Human Sperm Morphology: Top Models,Underdogs or Biometrics?

用于评估"理想"形态的精子比例的严格方法第5版《世界卫生组织人类精液分析实验室技术手册》(简称手册)推荐。这基于"理想"精子形态与生育力之间相关的统计学研究,以及目前一致认为精子形态的评估应该是研究生育力的主要手段。即使在可育男性的精子中"理想"形态精子所占比例也很低,但是"理想"精子形态的概念一直存在,这是一个备受争议的话题。在很长一段时间里认为,对各种异常精子进行详细分类是可选择的,甚至是多余的。该观点也反映在较早版本的世界卫生组织(WHO)手册中。然而,一些最近的研究表明,仔细评估异常精子形态对不孕症诊断、生育能力预测以及基础或公共健康研究有重要意义。一种将视频显微扫描技术和计算机视觉结合起来,并且是唯一能够评估精子生物统计学连续性的方法,已成功应用于最近的几个临床、基础和毒理学研究中。详细的精子形态的视觉评估(包括对异常精子分类得出的畸形精子指数)和更加现代的以计算机为基础的方法实际上是相辅相成的,虽然往往认为是多余的。要依据研究的领域(临床、基础、毒理学)和需要解决的问题选取最适当的方法。简要地讨论每种方法的优势以及某些限制。

The assessment of the percentage of spermatozoa having an ＇ideal＇ morphology using socalled strict method is the method recommended in the latest edition of the World Health Organization（WHO） laboratory manual for semen analysis. This recommendation is a result of the statistical association between ＇ideal＇ sperm morphology and fertility, and of the current general belief that sperm morphology assessment should be used primarily as a fertility tool. The notion of an ＇ideal＇ sperm morphology has persisted despite the very low percentage of such spermatozoa in the semen of fertile men, a subject of intense controversy. The detailed categorization of each abnormal spermatozoon has thus, for a long time, been considered optional and partially redundant, an idea which is reflected in the earlier editions of the WHO manual. However, several recent studies have shown the importance of carefully assessing abnormal sperm morphology for use in the diagnosis of infertility, to determine fertility prognosis, and for basic or public health studies. One approach, which combines videomicroscopy and computer vision, and is the only approach able to assess the continuum of sperm biometrics, has been used successfully in several recent clinical, basic and toxicology studies. In summary, the visual assessment of detailed sperm morphology-including the categorization of anomalies allowing arithmetically derived indices of teratozoospermia-and the more modem computer-based approaches, although often considered to be redundant, are in fact complementary. The choice of the most appropriate method depends on the field of investigation（clinical, research, toxicology） and the problem being addressed. Each approach has advantages as well as certain limitations, which will be discussed briefly herein.