Changhai Hospital, Second Military Medical University, 168 Changhai Road, Shanghai, China.
Stem Cell Rev Rep. 2011 Sep;7(3):714-21. doi: 10.1007/s12015-011-9236-8.
Infertility is an emotionally charged problem, and it is a condition of increasing incidence. In addition, in 40% to 60% of all infertile couples, it was the male who had a problem that led to infertility. Among the male fertility problems, non-obstructive azoospermia (NOA) (caused by testis failure or impaired spermatogenesis) is the most prevalent. Despite enormous clinical and experimental efforts, treatment of this disorder--assistant reproduction technique (ART) with donor spermatozoa remains controversial. We present the hypothesis that induced pluripotent stem (iPS) cell derived spermatozoa can be a potential source for male gametes for patients with NOA; we support this with the following three evidence: the first is the generation of viable, live-born, fertile mature organism from iPS cells; the second is the successful induced differentiation of male gametes from pluripotent cells in vitro; and the last is the wide use of intracytoplasmic sperm injection (ICSI) in human assisted reproduction. If the hiPS derived spermatozoa prove practical in the generation offspring with ICSI, this method might be able to grant a new chance for NOA patients to have their genetic children with fewer emotional, ethical and legislative problems. To ensure the safety of the technology itself and the production of healthy offspring, further investigations are needed. We also suggest several laboratory and clinical approaches for testing our hypothesis.
不育症是一个充满情感的问题,而且其发病率呈上升趋势。此外,在所有不育夫妇中,有 40% 到 60%的情况是男性存在导致不育的问题。在男性生育问题中,非阻塞性无精子症(NOA)(由睾丸衰竭或受损的精子发生引起)最为常见。尽管进行了大量的临床和实验努力,但对这种疾病的治疗——使用供体精子的辅助生殖技术(ART)仍然存在争议。我们提出了一个假设,即诱导多能干细胞(iPS)细胞衍生的精子可以成为 NOA 患者的男性配子的潜在来源;我们通过以下三个证据来支持这一假设:第一个是从 iPS 细胞中产生有活力、有生命、能生育的成熟生物体;第二个是在体外从多能细胞成功诱导分化出雄性配子;最后一个是胞质内精子注射(ICSI)在人类辅助生殖中的广泛应用。如果 hiPS 衍生的精子在使用 ICSI 产生后代方面被证明是可行的,那么这种方法可能能够为 NOA 患者提供一个新的机会,让他们拥有自己的遗传后代,同时减少情感、伦理和法律问题。为了确保技术本身和健康后代的生产安全,需要进一步的研究。我们还提出了一些实验室和临床方法来检验我们的假设。