Vicino M, Loverro G, Simonetti S, Mei L, Selvaggi L
II Clinica Ostetrica Ginecologica, Policlinico, Università degli Studi, Bari.
Minerva Ginecol. 1999 Nov;51(11):413-20.
An adverse effect of leukocytospermia in seminal fluid on motility and fertilizing power of spermatozoa has been described. This detrimental effect could be mediated by radical oxygen species (ROS). Recently, a direct effect on nuclear DNA of sperm induced by ROS has been described, although the chance of fertilization did not seem altered during ICSI procedure. Aim of this prospective case-control study was to compare the outcome of results in term of fertilization rate and embryo quality in patients with and without idiopathic leukocytospermia during IVF and ICSI cycles.
Seventy-two patients selected for a program of IVF and ICSI were admitted in the study. Fourty-two patients underwent IVF procedure, 14 with idiopathic leukocytospermia and 28 without, and thirty underwent ICSI procedure, 16 with leukocytospermia and 14 without leukocytospermia.
Statistical significant differences on cleavage rate of embryos between leukocytospermia and control group in IVF cycles were observed. In ICSI procedure a low fertilization, cleavage rate and percentage of good embyros in the presence of leukocytospermia were evidenced.
The presence of a significant number of leukocytes in semen, even in idiopathic condition, could affect the results of IVF and ICSI procedure. An adverse effect of lipoperoxidation process of plasma membrane and damage of nuclear chromatin of sperm, as result of leukocyte contamination could be hypothesized and future studies needed in order to verify the role of ROS on sperm functions.
精液中白细胞增多症对精子活力和受精能力的不良影响已被描述。这种有害影响可能由活性氧（ROS）介导。最近，已经描述了ROS对精子核DNA的直接影响，尽管在卵胞浆内单精子注射（ICSI）过程中受精机会似乎没有改变。这项前瞻性病例对照研究的目的是比较体外受精（IVF）和ICSI周期中患有和未患有特发性白细胞增多症的患者在受精率和胚胎质量方面的结果。
72名入选IVF和ICSI项目的患者被纳入研究。42名患者接受IVF程序，其中14名患有特发性白细胞增多症，28名没有；30名接受ICSI程序，其中16名患有白细胞增多症，14名没有白细胞增多症。
在IVF周期中，观察到白细胞增多症组和对照组之间胚胎分裂率存在统计学显著差异。在ICSI程序中，发现存在白细胞增多症时受精率、分裂率和优质胚胎百分比都较低。
精液中存在大量白细胞，即使在特发性情况下，也可能影响IVF和ICSI程序的结果。可以假设白细胞污染导致的质膜脂质过氧化过程和精子核染色质损伤的不良影响，未来需要进行研究以验证ROS对精子功能的作用。
