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[生育男性与不育男性精子形态功能特征的比较研究及其与受精能力的关系]

[Comparative study of the morpho-functional features of the sperm of fertile and infertile men and their relation to fertilizing ability].

作者信息

Chavarría M E, Reyes A

机构信息

Instituto Nacional de Perinatología, División de Investigación Biomédica Montes Urales, Lomas de Virreyes, México, D.F.

出版信息

Ginecol Obstet Mex. 1991 Jul;59:229-37.

PMID:1769606
Abstract

The recent advances in assisted reproduction procedures have helped to the better understanding of the female reproductive physiology and pathology, however, male infertility remains as a poor explained medical problem, nevertheless it occurs in almost 50% of infertile couples. Oligoasthenozoospermia is one of the more common causes of male infertility, therefore we measured in 10 patients with this diagnosis and in 10 fertile euspermic men, besides the parameters included in the standard semen analysis, the quantitative motility (photography method), capacitation-acrosome reaction and the sperm ability to fertilize zona-free hamster oocytes, with the aim to correlate the morphofunctional characteristics of the male gametes with their fertilizing capacity. The results showed significant differences in every parameter studied, including the correlation analysis. In relation with the in vitro induction of the acrosome reaction in both groups, we found significant correlations of the sperm fertilizing ability and the progressive sperm motility with this parameter (fertile group: RS = 0.834, P less than 0.005 & RS = 0.612, P less than 0.05; infertile group: RS = 0.986, P less than 0.001 & RS = 0.536, P less than 0.05 respectively), nevertheless the sperm rate which completed this process was low in relation to the total sperm population even in the fertile men (9.4 +/- 2.0% & 4.4 +/- 2.5% acrosome reacted cells after 18 h of incubation, in the fertile and infertile males respectively). The results also showed the presence of fully capacitated spermatozoa in both groups, since they penetrated the zona-free hamster eggs and decondensed their chromatin (73.9 +/- 13.4% & 10.4 +/- 7.7% penetrated eggs in the euspermic and oligoasthenozoospermic individuals respectively), however, the spermatozoa from the oligoasthenozoospermic men showed low polyspermy indexes too (0.1 penetrated spermatozoa/inseminated oocyte). In this last group we found, in addition, that the mean sperm velocity and the abnormal sperm morphology rate showed significant correlations with the fertilizing ability of the male gametes too (RS = 0.986, P less than 0.005 & RS = -0.942, P less than 0.005. respectively). These data allow us to suggest that before an infertile man is involved in any assisted reproduction program, the presence of possible morphofunctional alterations in the spermatozoa be analyzed, with the aim to be able to make a better prognosis about the success with these patients.

摘要

辅助生殖技术的最新进展有助于更好地理解女性生殖生理和病理,但男性不育仍然是一个难以解释的医学问题,然而,几乎50%的不育夫妇都存在男性不育问题。少弱精子症是男性不育较常见的原因之一,因此,我们对10例诊断为此病的患者和10例生育能力正常的男性进行了测量,除了标准精液分析中的参数外,还测量了定量活力(摄影法)、获能-顶体反应以及精子使无透明带仓鼠卵母细胞受精的能力,目的是将雄配子的形态功能特征与其受精能力相关联。结果显示,在研究的每个参数上,包括相关性分析,都存在显著差异。关于两组体外诱导顶体反应的情况,我们发现精子受精能力和精子前向运动与该参数存在显著相关性(生育能力正常组:RS = 0.834,P < 0.005;RS = 0.612,P < 0.05;不育组:RS = 0.986,P < 0.001;RS = 0.536,P < 0.05),然而,即使在生育能力正常的男性中,完成此过程的精子比例相对于总精子数量也较低(分别在孵育18小时后,生育能力正常和不育男性中顶体反应细胞分别为9.4±2.0%和4.4±2.5%)。结果还显示两组中都存在完全获能的精子,因为它们穿透了无透明带仓鼠卵并使染色质解聚(生育能力正常和少弱精子症个体中分别有73.9±13.4%和10.4±7.7%的卵被穿透),然而,少弱精子症男性的精子多精受精指数也较低(0.1个穿透精子/授精卵母细胞)。在最后一组中,我们还发现,平均精子速度和异常精子形态率也与雄配子的受精能力存在显著相关性(分别为RS = 0.986,P < 0.005;RS = -0.942,P < 0.005)。这些数据使我们建议,在不育男性参与任何辅助生殖计划之前,应对精子中可能存在的形态功能改变进行分析,以便能够对这些患者治疗成功的可能性做出更好的预后判断。

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