Tesarik Jan
MAR&Gen, Molecular Assisted Reproduction and Genetics, Gracia 36, 18002 Granada, Spain, Laboratoire d'Eylau, 55 rue Saint Didier, 75116 Paris, France.
Reprod Biomed Online. 2005 Mar;10(3):370-5. doi: 10.1016/s1472-6483(10)61798-1.
Cell divisions in the human preimplantation embryo can be compromised by deficiencies in sperm nuclear genome or sperm-derived developmentally relevant cytoplasmic factors, oocyte activating substance and centriole. Sperm nuclear deficiencies are usually not detected before the 8-cell stage of embryo development, when a major expression of sperm-derived genes has begun. Sperm cytoplasmic deficiencies can be detected as early as the 1-cell zygote and then throughout the preimplantation development. The terms 'late paternal effect' and 'early paternal effect' have been suggested to denote these two pathological conditions. The late paternal effect is associated with an increased incidence of sperm DNA fragmentation. No association with sperm DNA damage has been found for the early paternal effect. The diagnosis of the late paternal effect is thus based on the examination of sperm DNA integrity, which should be performed in cases of repeated assisted reproduction failure even if morphologically normal embryos result from fertilization with the patient's spermatozoa. The only element leading to the diagnosis of the early paternal effect is poor zygote and embryo morphology and low cleavage speed. The absence of increased sperm DNA damage does not exclude the presence of this pathology. ICSI with testicular spermatozoa has recently been shown to be an efficient treatment for the late paternal effect. The use of oral antioxidant treatment in this indication has also given promising results.
人类植入前胚胎的细胞分裂可能会因精子核基因组缺陷、精子来源的与发育相关的细胞质因子、卵母细胞激活物质和中心粒的缺乏而受到损害。精子核缺陷通常在胚胎发育的8细胞阶段之前无法检测到，此时精子来源基因的主要表达已经开始。精子细胞质缺陷最早可在单细胞受精卵阶段检测到，然后在整个植入前发育过程中都能检测到。“晚期父源效应”和“早期父源效应”这两个术语已被用来表示这两种病理状况。晚期父源效应与精子DNA片段化发生率增加有关。尚未发现早期父源效应与精子DNA损伤有关。因此，晚期父源效应的诊断基于对精子DNA完整性的检查，即使患者精子受精产生的胚胎形态正常，在反复辅助生殖失败的情况下也应进行此项检查。导致早期父源效应诊断的唯一因素是受精卵和胚胎形态不佳以及分裂速度缓慢。精子DNA损伤没有增加并不排除存在这种病理状况。最近已证明，使用睾丸精子进行卵胞浆内单精子注射（ICSI）是治疗晚期父源效应的有效方法。在这种情况下使用口服抗氧化剂治疗也取得了令人鼓舞的结果。
