改良优选方法对精子质量和ART结局的影响的研究进展

Effects of advanced selection methods on sperm quality and ART outcome:An update

精子优选是辅助生殖技术(ART)的重要环节,目前的常规精液准备技术并不能有效筛选所有可能影响精子受精能力的内在因素。近年来,基于表面电荷、凋亡、膜成熟度和超微形态的改良精子优选方法逐渐受到关注,通过这些方法进行高质量精子的选择可改善精子DNA完整性,增加受精率和妊娠率。本篇综述将简要介绍这些改良精子优选方法的原理、方法、步骤,并对其临床应用进行评价,对这些方法的可行性、安全性及对精子质量和ART结局的影响进行总结,同时也会强调其对ART结局影响的局限性、存在争议及进一步研究的必要性。

Sperm selection plays an important role in assisted reproductive technology. Current routine semen preparation techniques do not inclusively target all intrinsic sperm characteristics that may impact the fertilization potential. In recent years,advanced selection methods based on：surface charge,apoptosis,membrane maturity and ultramorphology have been recently developed. Selection of high-quality sperm including improvements in DNA integrity,resulted from the application of these methods. Fertilization and pregnancy rates showed improvement following some of the advanced sperm selection techniques. We will describe their feasibility,safety and effects on sperm quality and ART outcomes. The limitations of studies describing the effects of using advanced sperm selection methods on ART outcomes,including small sample size will be highlighted. Controversies will be discussed and suggestions for further research provided. To summarize the relevant literature on advanced sperm selection methods used in routine ART treatment and to make recommendations on their clinical application.