胞浆内形态学筛选精子注射(IMSI)技术与精子优选

Intracytoplasmic morphologically selected sperm injection (IMSI) and optimal selection of sperm

多种研究表明严重头部形态异常精子与受精率、着床率和妊娠率低紧密相关。选择形态优良精子用于辅助生殖治疗是提高其临床结局的有效方式。经低放大倍率光学显微镜(×200)所选出的正常精子会包含一些细微结构缺陷,其用于卵胞浆单精子注射(Intracytoplasmic sperm injection,ICSI),有时会导致受精失败或胚胎发育停滞。胞浆内形态学筛选精子注射(Intracytoplasmic morphologically selected sperm injection,IMSI)技术是ICSI与运动精子细胞器形态学检查(Motile sperm organelles morphology examination,MSOME)技术的完美结合,IMSI配备了微分干涉相差显微观测与数位成像技术,使其可在高放大倍率下(×6 600)对运动的活体精子进行形态质量评价,选择头部无/少空泡精子用于显微注射,从而提高受精率、着床率和妊娠率以及降低流产率。本文主要综述了IMSI技术的发展及其在精子优选方面的应用并对IMSI临床结局进行分析,为其应用拓展及进一步功能开发提供理论指导。

Myriads of studies indicate that sperm with severe head morphological abnormalities is closely associated with low fertilization, implantation and pregnancy rate. Selecting high quality sperm used for ART （assisted reproductive techniques） is an effective way to improve the clinic outcome. A normal sperm selected under a optical microscope with low magnification （ fertilization failure or arrest of embryonic intracytoplasmic morphologically selected x200） could contain some ultrastructural defects, which may result in development after ICSI （Intracytoplasmic sperm injection）. However, sperm injection （ IMSI ） shows the perfect match between ICSI and MSOME （Motile sperm organelles morphology examination） , which can evaluate the quality of sperm morpholo- gy and cherry-pick sperm with none or less vacuole for microinjection to increase the rates of fertilization, im- plantation and pregnancy, as well as decrease the abortion rate. The examination is performed using a differenti- al interference contrast microscopy and digital imaging technologyto achieve a magnification up to 6 600x. This review mainly focus on the development history of IMSI techniques, its application and analysis of clinical outcomes, which will provide some theoretical directions to and further development.