男性不孕症患者精子超微结构异常的电镜诊断

Electron microscopic diagnosis on ultrastructural abnormality of spermatozoon in male factor infertility

对 6 3例男性不孕症患者的精子做了电镜超微结构观察 ,并做了与之对应的光镜及常规检查。除 1 1例为死精症外 ,5 2例均为精子结构异常。 5 2例中 4 0例为头部异常 ,1 2例尾异常。头部异常主要为无顶体、顶体发育不良和染色质发育不良。尾异常主要为 2 + 9+ 9结构异常及接柱异常。结果显示精子电镜超微结构检查能很好地避免误诊 。

We examined 63 samples of semen of male factor infertility including 11 of necrospermia by electron microscopy. There were 40 cases of head abnormalities of sperm and 12 cases tail defects. Head abnormalities included agenesis of the acrosome, acrosomal hypoplasia and chromatin immaturity. Tail defects included defects of outer dense fibers, axonemal and connecting piece. Necrospermia was based on the observation of degenerative changes that usually involve all sperm components. There were fragmentation or complete disappearance of plasma membrane, extreme extracellular dissolution of the acrosomal substance, karyolysis, swelling of the mitochondria and fragmentation of their cristae, disorganization and breakdown of the riblike structure of the fibrous sheath, and filamentous transformation and / or disappearance of the microtubules of the proximal centriole and of the axoneme. Because of the superior preservation of the specimen and the high resolution of the electron microscope, ultrastructural analysis considerably enhances the quality of semen study and might give an accurate diagnosis of male factor infertility.