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少精子症不育男性中精子与透明带相互作用缺陷的高发生率。

High frequency of defective sperm-zona pellucida interaction in oligozoospermic infertile men.

作者信息

Liu De Yi, Baker H W Gordon

机构信息

University of Melbourne Department of Obstetrics and Gynaecology, Reproductive Services, Royal Women's Hospital and Melbourne IVF, Victoria 3035, Australia.

出版信息

Hum Reprod. 2004 Feb;19(2):228-33. doi: 10.1093/humrep/deh067.

Abstract

BACKGROUND

The ability of sperm to interact with the zona pellucida (ZP) plays a critical role during the process of human fertilization. The aim of this study is to determine frequency of defective sperm-ZP interaction in oligozoospermic infertile men.

METHODS

Sperm-ZP binding assays and the ZP-induced acrosome reaction (AR) were performed in 72 infertile men with a sperm concentration <20 x 10(6)/ml. Oocytes that had previously failed to fertilize in a clinical IVF programme were used for the tests. Motile sperm (2 x 10(6)/ml) selected by swim-up from each semen sample were incubated with four oocytes for 2 h. The number of sperm bound per ZP and the ZP-induced AR were assessed. Under these conditions, an average of < or =40 sperm bound/ZP was defined as low sperm-ZP binding and a ZP-induced AR < or =16% was defined as low ZP-induced AR.

RESULTS

In the 72 oligozoospermic men, 28% (20/72) had low sperm-ZP binding. Of those with normal sperm-ZP binding, 69% (36/52) had low ZP-induced AR. Overall, 78% (56/72) had either low ZP-binding or normal ZP binding but low ZP-induced AR. This means that only 22% (16/72) had both normal sperm-ZP binding and normal ZP-induced AR.

CONCLUSION

Oligozoospermic men have a very high frequency of defective sperm-ZP interaction, consistent with their low natural fertility or low fertilization rate in conventional IVF. Infertile couples with oligozoospermic semen should be treated by ICSI rather than by conventional IVF.

摘要

背景

精子与透明带(ZP)相互作用的能力在人类受精过程中起着关键作用。本研究的目的是确定少精子症不育男性中精子与ZP相互作用缺陷的发生率。

方法

对72名精子浓度<20×10⁶/ml的不育男性进行精子-ZP结合试验和ZP诱导的顶体反应(AR)。使用先前在临床体外受精程序中未能受精的卵母细胞进行测试。从每个精液样本中通过上浮法选出的活动精子(2×10⁶/ml)与四个卵母细胞孵育2小时。评估每个ZP结合的精子数量和ZP诱导的AR。在这些条件下,平均每个ZP结合的精子数≤40被定义为低精子-ZP结合,ZP诱导的AR≤16%被定义为低ZP诱导的AR。

结果

在72名少精子症男性中,28%(20/72)精子-ZP结合低。在精子-ZP结合正常的男性中,69%(36/52)ZP诱导的AR低。总体而言,78%(56/72)要么ZP结合低,要么ZP结合正常但ZP诱导的AR低。这意味着只有22%(16/72)精子-ZP结合和ZP诱导的AR均正常。

结论

少精子症男性精子-ZP相互作用缺陷的发生率非常高,这与他们自然生育率低或传统体外受精受精率低一致。少精子症精液的不育夫妇应采用卵胞浆内单精子注射(ICSI)而非传统体外受精进行治疗。

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