Funaro Michael, Paduch Darius A
Department of Urology and Reproductive Medicine, Weill Cornell Medical College, New York, NY, USA.
Methods Mol Biol. 2014;1154:233-50. doi: 10.1007/978-1-4939-0659-8_9.
Diagnostic tests should detect disease, have prognostic value, and aid in clinical decision making. Nowhere else in laboratory medicine does one have to interpret a subject's results within the dynamic of a couple as in reproductive medicine. Abnormal markers of male reproduction do not necessarily mean sterility, but instead indicate problems with spermatogenesis, sperm maturation, transport through epididymis and ejaculatory duct, or abnormal ejaculatory function. Decades of research suggest that one test will never fit all scenarios and a battery of assays evaluating different aspects of male reproduction will likely have the best prognostic value. There is a strong need for standardization and harmonization of evolving assays to establish their clinical relevance. Next-generation genome sequencing and the discovery of small noncoding RNAs in sperm already are changing the field and permit further insight into the biology of male reproduction as well as offer new diagnostic tests.
诊断测试应能检测疾病、具有预后价值并有助于临床决策。在检验医学的其他领域，没有哪个领域像生殖医学那样，必须在夫妻关系的动态背景下解读受试者的检测结果。男性生殖的异常标志物不一定意味着不育，而是表明精子发生、精子成熟、通过附睾和射精管的运输或射精功能异常等问题。数十年的研究表明，单一测试永远无法适用于所有情况，而一系列评估男性生殖不同方面的检测可能具有最佳的预后价值。迫切需要对不断发展的检测方法进行标准化和统一，以确定其临床相关性。下一代基因组测序以及精子中小非编码RNA的发现已经在改变这一领域，并有助于进一步深入了解男性生殖生物学，同时也提供了新的诊断测试方法。
