Biologie de la Reproduction/CECOS, Hôpital Cochin, Paris, France.
Asian J Androl. 2010 Jan;12(1):36-46. doi: 10.1038/aja.2009.8.
The assessment of the percentage of spermatozoa having an 'ideal' morphology using so-called strict method is the method recommended in the latest edition of the World Health Organization (WHO) laboratory manual for semen analysis. This recommendation is a result of the statistical association between 'ideal' sperm morphology and fertility, and of the current general belief that sperm morphology assessment should be used primarily as a fertility tool. The notion of an 'ideal' sperm morphology has persisted despite the very low percentage of such spermatozoa in the semen of fertile men, a subject of intense controversy. The detailed categorization of each abnormal spermatozoon has thus, for a long time, been considered optional and partially redundant, an idea which is reflected in the earlier editions of the WHO manual. However, several recent studies have shown the importance of carefully assessing abnormal sperm morphology for use in the diagnosis of infertility, to determine fertility prognosis, and for basic or public health studies. One approach, which combines videomicroscopy and computer vision, and is the only approach able to assess the continuum of sperm biometrics, has been used successfully in several recent clinical, basic and toxicology studies. In summary, the visual assessment of detailed sperm morphology-including the categorization of anomalies allowing arithmetically derived indices of teratozoospermia-and the more modern computer-based approaches, although often considered to be redundant, are in fact complementary. The choice of the most appropriate method depends on the field of investigation (clinical, research, toxicology) and the problem being addressed. Each approach has advantages as well as certain limitations, which will be discussed briefly herein.
使用所谓的严格方法评估具有“理想”形态的精子百分比，是世界卫生组织（WHO）最新版精液分析实验室手册中推荐的方法。这种推荐是基于“理想”精子形态与生育力之间的统计学关联，以及当前普遍认为精子形态评估应主要作为生育力工具的观点。尽管在生育力正常男性的精液中，具有这种形态的精子比例非常低，但“理想”精子形态的概念仍然存在，这是一个备受争议的话题。因此，很长一段时间以来，对每个异常精子进行详细分类被认为是可选的和部分冗余的，这一观点反映在 WHO 手册的早期版本中。然而，最近的几项研究表明，仔细评估异常精子形态对于诊断不育症、确定生育预后以及进行基础或公共卫生研究非常重要。一种结合视频显微镜和计算机视觉的方法，是唯一能够评估精子生物计量学连续体的方法，已成功应用于最近的几项临床、基础和毒理学研究中。总之，详细的精子形态学的视觉评估——包括对畸形的分类，允许对畸形精子症进行算术衍生指数的评估——以及更现代的基于计算机的方法，尽管通常被认为是冗余的，但实际上是互补的。最适合的方法的选择取决于研究领域（临床、研究、毒理学）和要解决的问题。每种方法都有其优点和某些局限性，本文将简要讨论这些问题。
