《WHO人类精液检查与处理实验室手册》(第6版)修订内容的启示

Enlightenment from the contents revised of the 6th edition of the WHO Laboratory Manual for the Examination and Processing of Human Semen

《WHO人类精液检查与处理实验室手册》是人类精液检查与精子评估程序和方法的重要参考文献。在手册第6版,精子活力采用4级分类系统评定,精子形态使用结构化顺序分析,不再表述精液参数参考值范围、限值和精液质量术语,强调实验室的质量保证和质量控制,删除了精子与宫颈黏液、卵透明带和卵母细胞相互作用试验,以及去透明带仓鼠卵穿透试验;新增加检测精子DNA损伤、精子染色质、精子非整倍体和精液白细胞介素的试验,新介绍玻璃化冷冻精子、计算机辅助精子分析(computer-aided sperm analysis,CASA)系统评价精子超活化运动、磁激活细胞分选术制备精子和检查射精顺序的方法。手册第6版中保留、修订的内容,在一定程度反映了国际上现今精液检查与精子评估的标准化、实用性和发展方向,对我国男科学实验室的发展有指导和促进作用。

The WHO Laboratory Manualfor the Examination and Processing of Human Semen is an important reference document for procedures and methods for human semen examination and sperm evaluation.In the 6th edition of the manual,a four-category system for grading sperm motility is recommended,sperm morphology analysis using a systematic approach is described,and both quality assurance and quality control are given more attention.Reference values of semen characteristics and nomenclature of semen are no longer used.Obsolete tests such as the human oocyte and human zona pellucida binding and the hamster oocyte penetration tests have been removed.On the other hand,assays to detect sperm DNA fragmentation,sperm chromatin,sperm aneuploidy and semen interleukin have been added.In addition,methods concerning vitrification of sperm freezing,computer-aided sperm analysis(CASA)evaluation of sperm hyperactivation,magnetic activated cell sorting for sperm selection,and assessment of ejaculation sequence have been described.The contents retained and revised in the 6th edition of the manual reflect,to a certain extent,the standardization,practicality and developmental direction of semen examination and sperm evaluation in the world,which will benefit the development of andrology laboratories in China.