Liu De Yi, Baker H W Gordon
University of Melbourne Department of Obstetrics and Gynaecology, Reproductive Services, Royal Women's Hospital and Melbourne IVF, Victoria 3035, Australia.
Hum Reprod. 2004 Feb;19(2):228-33. doi: 10.1093/humrep/deh067.
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.
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.
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.
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.
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。
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。
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。
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。
