Reproductive and Developmental Biology, Maternal and Child Health Science Laboratories, Centre for Oncology and Molecular Medicine, Ninewells Hospital, University of Dundee, Dundee, DD1 9SY, Scotland, UK.
Asian J Androl. 2011 Jan;13(1):53-8. doi: 10.1038/aja.2010.63. Epub 2010 Nov 22.
Sperm dysfunction is the single most common cause of infertility, yet what is remarkable is that, there is no drug a man can take or add to his spermatozoa in vitro to improve fertility. One reason for the lack of progress in this area is that our understanding of the cellular and molecular workings of the mature spermatazoon is limited. However, over the last few years there has been considerable progress in our knowledge base and in addressing new methods to diagnose sperm dysfunction. We review the current state of the field and provide insights for further development. We conclude that: (i) there is little to be gained from more studies identifying/categorizing various populations of men using a basic semen assessment, where an effort is required in making sure the analysis is performed in an appropriate high quality way; (ii) technological development is likely to bring the reality of sperm function testing closer to implementation into the clinical pathways. In doing this, these assays must be robust, cheap (or more appropriately termed cost effective), easy to use and clinically useful; and (iii) clinical necessity, e.g., the need to identify the highest quality spermatozoon for injection is driving basic research forward. This is an exciting time to be an andrologist and, likely, a fruitful one.
精子功能障碍是导致不孕的最常见原因，但令人惊讶的是，目前还没有一种药物可以让男性服用或添加到精子中，以提高生育能力。在这一领域缺乏进展的一个原因是，我们对成熟精子的细胞和分子功能的理解有限。然而，在过去几年中，我们在知识基础和解决精子功能障碍的新方法方面取得了相当大的进展。我们回顾了该领域的现状，并为进一步发展提供了一些见解。我们的结论是：（i）通过基本的精液评估来识别/分类各种男性人群的研究，几乎没有什么收获，需要努力确保分析以适当的高质量方式进行；（ii）技术的发展可能会使精子功能测试更接近临床途径的实施。在这样做的过程中，这些检测必须是可靠的、廉价的（或者更恰当地说，具有成本效益）、易于使用和具有临床实用性；（iii）临床必要性，例如，需要识别用于注射的最高质量的精子，正在推动基础研究的发展。这是一个令人兴奋的时代，作为一名男科医生，可能也是一个富有成效的时代。
