de Kretser D M, Huidobro C, Southwick G J, Temple-Smith P D
Institute of Reproduction and Development, Monash University, Clayton, Victoria, Australia.
J Reprod Fertil Suppl. 1998;53:271-5.
This review describes the role of the epididymis in human infertility, by analysing the results of epididymovasostomies which confirm that the more distal the site of obstruction the greater the chance of fertility. The use of epididymal spermatozoa for in vitro fertilization (IVF) yielded poor results in contrast to intracytoplasmic sperm injection using either epididymal or testicular spermatozoa. The nature of the pathology causing obstructive azoospermia is examined reviewing in particular the possible role of mercury toxicity in Young's syndrome. This review describes the results of studies that show that the level of obstruction within the epididymis is correlated with the presence of sperm antibodies and distal obstructions are associated with the presence of sperm antibodies. The demonstration that necrozoospermia decreases with increased sperm transport through the epididymis, when combined with the observation of normal testicular sperm morphology, represents the basis for the disorder termed epididymal necrozoospermia. However, to date the nature of the epididymal pathology causing this disorder remains obscure.
本综述通过分析附睾输精管吻合术的结果，阐述了附睾在人类不育症中的作用，这些结果证实梗阻部位越靠远端，生育的机会就越大。与使用附睾或睾丸精子进行胞浆内精子注射相比，使用附睾精子进行体外受精（IVF）的效果较差。对导致梗阻性无精子症的病理性质进行了研究，特别回顾了汞中毒在杨氏综合征中可能发挥的作用。本综述介绍了一些研究结果，这些结果表明附睾内的梗阻程度与精子抗体的存在相关，远端梗阻与精子抗体的存在有关。死精子症随着精子通过附睾运输的增加而减少，这一现象与睾丸精子形态正常的观察结果相结合，构成了所谓附睾死精子症这一病症的基础。然而，迄今为止，导致这种病症的附睾病理性质仍不清楚。
