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电镜和荧光显微镜检查部分性葡萄胎病例的精液分析显示,异常形态、二倍体和四倍体的发生率较高。

Semen analysis by electron and fluorescence microscopy in a case of partial hydatidiform mole reveals a high incidence of abnormal morphology, diploidy, and tetraploidy.

机构信息

Section of Reproductive Medicine, First Department of Obstetrics and Gynaecology, Aristotle University Medical School, Papageorgiou General Hospital, Thessaloniki, Greece.

出版信息

Fertil Steril. 2011 Jun;95(7):2430.e1-5. doi: 10.1016/j.fertnstert.2011.01.161. Epub 2011 Feb 26.

DOI:10.1016/j.fertnstert.2011.01.161
PMID:21354560
Abstract

OBJECTIVE

To perform a highly detailed semen analysis in a man whose wife had a partial mole.

DESIGN

Case report.

SETTING

Gynecology departments of two university hospitals and a laboratory of histology/embryology.

PATIENT(S): A 32-year-old man whose wife had a partial mole.

INTERVENTION(S): Sperm characteristics were examined by light microscopy, morphology was analysed by electron microscopy (TEM), DNA fragmentation was evaluated by TUNEL using fluorescence microscopy, and chromosomal abnormalities were assessed by fluorescence in situ hybridization using probes for chromosomes 13, 15, 16, 18, 21, 22, X, and Y.

MAIN OUTCOME MEASURE(S): Sperm count, motility, morphology, DNA fragmentation, and incidence of diploidy, tetraploidy, and aneuploidy.

RESULT(S): Sperm concentration was 61 million/mL, with 31% progressive motility and 4% normal morphology. TEM revealed a high incidence of head, neck, and tail abnormalities as well as the presence of phagocytes. DNA fragmentation was within normal limits (11.6%). Aneuploidy levels were low for all chromosomes tested. However, there was a high level of diploidy, with XY, XX, and YY constitution. Tetraploid sperm (XXYY) were also noted.

CONCLUSION(S): Semen analysis revealed a high incidence of abnormal morphology and increased diploidy. It may be important to perform FISH testing, to verify increased diploidy in sperm, in men whose wives have had partial moles. These couples could be informed of the option to have preimplantation genetic diagnosis as a means to distinguish between diploid and triploid embryos arising from fertilization of a haploid egg by diploid sperm.

摘要

目的

对妻子患有部分葡萄胎的男性进行高度详细的精液分析。

设计

病例报告。

地点

两家大学医院的妇科部门和一个组织学/胚胎学实验室。

患者

一位 32 岁的男性,其妻子患有部分葡萄胎。

干预措施

通过光学显微镜检查精子特征,通过电子显微镜(TEM)分析形态,通过荧光显微镜使用 TUNEL 评估 DNA 碎片化,并用针对染色体 13、15、16、18、21、22、X 和 Y 的荧光原位杂交评估染色体异常。

主要观察指标

精子计数、活力、形态、DNA 碎片化以及二倍体、四倍体和非整倍体的发生率。

结果

精子浓度为 6100 万/mL,前向运动精子比例为 31%,正常形态精子比例为 4%。TEM 显示头部、颈部和尾部异常以及吞噬细胞的存在发生率较高。DNA 碎片化在正常范围内(11.6%)。所有检测的染色体非整倍体水平都较低。然而,存在高水平的二倍体,包括 XY、XX 和 YY 构成。还注意到四倍体精子(XXYY)。

结论

精液分析显示异常形态发生率高且二倍体增加。对于妻子曾患有部分葡萄胎的男性,进行 FISH 测试以验证精子中二倍体的增加可能很重要。这些夫妇可以被告知选择进行植入前遗传学诊断,以区分由二倍体精子受精的二倍体和三倍体胚胎。

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