无精子症、隐匿精子症和死精子症能使自然怀孕率显著下降或不育，但这些严重男性不育症患者还可以选择ICSI治疗成为生物学父亲。本研究分析了这些精子经ICSI治疗后的受精和胚胎发育情况，对照组为同一治疗周期使用供精精子IVF治疗。取...无精子症、隐匿精子症和死精子症能使自然怀孕率显著下降或不育，但这些严重男性不育症患者还可以选择ICSI治疗成为生物学父亲。本研究分析了这些精子经ICSI治疗后的受精和胚胎发育情况，对照组为同一治疗周期使用供精精子IVF治疗。取卵当天，当两次取精所获的全部精子或手术获取的睾丸精子总数少于卵子数时，剩下的卵子使用供精精子IVF治疗。72对夫妇（73周期）共获取1117个成熟卵子，512个卵子用于夫精ICSI，另外605个用于供精IVF；与对照组相比，夫精非梗阻性无精子症组、隐匿精子症组和死精子症组的受精率都显著下降，分别为65.4% v s .83.2%（P〈0.001）、68.8%vs.75.5%（P〈0.05）、65.0% vs.85.2%（P〈0.05）；非梗阻性无精子症组的卵裂率与对照组相比也显著降低（96.4% vs.99.4%, P〈0.05），但优质胚胎率则无显著差异；隐匿精子症组和死精子症组的卵裂率和优质胚胎率与对照组相比均无显著差异。结论：尽管严重男性不育症所获精子经ICSI治疗后会显著降低受精能力，但已受精的胚胎发育潜能与对照组相比影响并不显著，临床结局令人满意。展开更多
Objective To study the identification of the cause of specific sperm abnormalities.Methods Two adult men with specific alterations in sperm morphology causing 100%immobility were included in this study. The study of s...Objective To study the identification of the cause of specific sperm abnormalities.Methods Two adult men with specific alterations in sperm morphology causing 100%immobility were included in this study. The study of sperm used: transmission electron microscopy(both patients); apoptotic markers, DNA fragmentation test and fluorescence in-situ hybridization(patient 1) and immunocytochemistry study of sperm flagellum using anti-β tubulin antibodies and ciliary activity test(patient 2).Results Increased DNA fragmentation(52.6%) and apoptosis biomarkers were detected in patient 1, and loss of the central pair of microtubules in patient 2(‘9+0'axoneme); the nasal ciliary activity was normal.Conclusion Results suggest an apoptotic origin of the abnormalities in the sperm from patient 1 and dysplasia of the fibrous sheath in patient 2.展开更多
基金The work was supported by grants from the Shanghai Committee of Science and Technology, China （Grant No. 09411964200）, the Major State Basic Research Development Program of China （973 Program, No. 2014CB943104） and the National Natural Science Foundation of China （81270744）.
文摘无精子症、隐匿精子症和死精子症能使自然怀孕率显著下降或不育，但这些严重男性不育症患者还可以选择ICSI治疗成为生物学父亲。本研究分析了这些精子经ICSI治疗后的受精和胚胎发育情况，对照组为同一治疗周期使用供精精子IVF治疗。取卵当天，当两次取精所获的全部精子或手术获取的睾丸精子总数少于卵子数时，剩下的卵子使用供精精子IVF治疗。72对夫妇（73周期）共获取1117个成熟卵子，512个卵子用于夫精ICSI，另外605个用于供精IVF；与对照组相比，夫精非梗阻性无精子症组、隐匿精子症组和死精子症组的受精率都显著下降，分别为65.4% v s .83.2%（P〈0.001）、68.8%vs.75.5%（P〈0.05）、65.0% vs.85.2%（P〈0.05）；非梗阻性无精子症组的卵裂率与对照组相比也显著降低（96.4% vs.99.4%, P〈0.05），但优质胚胎率则无显著差异；隐匿精子症组和死精子症组的卵裂率和优质胚胎率与对照组相比均无显著差异。结论：尽管严重男性不育症所获精子经ICSI治疗后会显著降低受精能力，但已受精的胚胎发育潜能与对照组相比影响并不显著，临床结局令人满意。
文摘Objective To study the identification of the cause of specific sperm abnormalities.Methods Two adult men with specific alterations in sperm morphology causing 100%immobility were included in this study. The study of sperm used: transmission electron microscopy(both patients); apoptotic markers, DNA fragmentation test and fluorescence in-situ hybridization(patient 1) and immunocytochemistry study of sperm flagellum using anti-β tubulin antibodies and ciliary activity test(patient 2).Results Increased DNA fragmentation(52.6%) and apoptosis biomarkers were detected in patient 1, and loss of the central pair of microtubules in patient 2(‘9+0'axoneme); the nasal ciliary activity was normal.Conclusion Results suggest an apoptotic origin of the abnormalities in the sperm from patient 1 and dysplasia of the fibrous sheath in patient 2.
