Garrido Nicolás, Remohí José, Martínez-Conejero José Antonio, García-Herrero Sandra, Pellicer Antonio, Meseguer Marcos
Instituto Universitario IVI and FIVI, Andrology Laboratory and Semen Bank, Plaza de la Policía Local 3, Valencia 46015, Spain.
Reprod Biomed Online. 2008 Dec;17(6):855-65. doi: 10.1016/s1472-6483(10)60415-4.
Semen analysis, as stated by the World Health Organization, is the only accepted tool to assess male fertility. However its predictive value to assess male capacity to initiate a pregnancy is limited. With the introduction of IVF (especially via intracytoplasmic sperm injection), infertility caused by diminished sperm production is frequently solved, but knowledge of sperm physiology remains very poor. Moreover, a percentage of males with apparently normal semen are unable to impregnate healthy women. Therefore, improvements in the diagnostic tools to assess male fertility potential are necessary. The aim of this review is to describe sperm molecular factors implicated in male fertility, demonstrated by their role in sperm physiology, the molecular differences found between fertile and infertile males, or by their influence on the results obtained in assisted reproduction treatments in terms of embryo quality and pregnancy achievement. From a search and objective evaluation of the currently available evidence, it is concluded that there is no unique factor able to predict male fertility, but several molecular factors are involved in sperm function and can potentially be considered as fertility markers. In this context, a complex molecular tool designed to analyse a battery of parameters seems to be necessary.
正如世界卫生组织所述，精液分析是评估男性生育能力的唯一被认可的工具。然而，其评估男性受孕能力的预测价值有限。随着体外受精技术（尤其是通过胞浆内单精子注射）的引入，精子生成减少导致的不育问题常常得以解决，但对精子生理学的了解仍然非常匮乏。此外，一部分精液看似正常的男性却无法使健康女性受孕。因此，有必要改进评估男性生育潜力的诊断工具。本综述的目的是描述与男性生育能力相关的精子分子因素，这些因素通过其在精子生理学中的作用、可育男性与不育男性之间发现的分子差异，或者通过它们对辅助生殖治疗中胚胎质量和妊娠结局所获结果的影响得以证明。通过对当前可得证据的检索和客观评估，得出的结论是，不存在能够预测男性生育能力的单一因素，但有几个分子因素参与精子功能，并且有可能被视为生育标志物。在这种情况下，设计一种用于分析一系列参数的复杂分子工具似乎是必要的。
