Garolla Andrea, Fortini Daniela, Menegazzo Massimo, De Toni Luca, Nicoletti Valentina, Moretti Afra, Selice Riccardo, Engl Bruno, Foresta Carlo
Centre for Male Gamete Cryopreservation, Department of Histology, Microbiology, and Medical Biotechnologies, University of Padova, Via Gabelli 63-35100, Padova, Italy.
Reprod Biomed Online. 2008 Nov;17(5):610-6. doi: 10.1016/s1472-6483(10)60307-0.
Sperm selection for intracytoplasmic sperm injection (ICSI), based on standard morphology, can fail to select normal cells, and actual methods to evaluate their physiological status do not allow their later use for ICSI. Some authors have demonstrated that sperm selection based on high-magnification morphology is associated with a better ICSI outcome, above all in subjects with severe testicular failure. In this study there was an evaluation of mitochondrial function, chromatin structure and sperm aneuploidies on whole sperm samples from 30 subjects: 10 normozoospermic controls and 20 patients that were severely oligozoospermic due to testicular damage or partial obstruction of the seminal ducts. All severely oligozoospermic patients showed worse mitochondrial function and chromatin status, while sperm aneuploidies were significantly increased only in those subjects with severe testicular damage (P < 0.001). In the latter patients the analysis of a single spermatozoon, performed after morphological selection by high-magnification microscopy, showed significantly better mitochondrial function, chromatin status and aneuploidy rate than observed in unselected cells (all P < 0.001). Interestingly, these parameters were further improved when nuclear vacuoles were lacking. These results suggest a strong relationship between high-magnification morphology and the status of spermatozoa, and they may explain the better results of ICSI obtained using spermatozoa selected by high-magnification microscopy.
基于标准形态学的卵胞浆内单精子注射（ICSI）精子选择可能无法选出正常细胞，且评估精子生理状态的实际方法不允许将其随后用于ICSI。一些作者已证明，基于高倍形态学的精子选择与更好的ICSI结果相关，尤其是在严重睾丸功能衰竭的患者中。在本研究中，对30名受试者的全精子样本进行了线粒体功能、染色质结构和精子非整倍体评估：10名正常精子对照组和20名因睾丸损伤或输精管部分阻塞而严重少精子症的患者。所有严重少精子症患者的线粒体功能和染色质状态均较差，而仅在那些有严重睾丸损伤的受试者中精子非整倍体显著增加（P < 0.001）。在后者中，经高倍显微镜形态学选择后对单个精子进行分析，结果显示其线粒体功能、染色质状态和非整倍体率均显著优于未选择的细胞（所有P < 0.001）。有趣的是，当缺乏核空泡时这些参数进一步改善。这些结果表明高倍形态学与精子状态之间存在密切关系，并且它们可能解释了使用经高倍显微镜选择的精子获得更好ICSI结果的原因。
