Garolla Andrea, Cosci Ilaria, Bertoldo Alessandro, Sartini Barbara, Boudjema Erbeha, Foresta Carlo
Department of Medicine, Section of Clinical Pathology and Unit for Human Reproduction Pathology, University of Padova, Via G. Modena 9, 35121, Padova, Italy.
Department of Medicine, Section of Clinical Pathology and Unit for Human Reproduction Pathology, University of Padova, Via G. Modena 9, 35121, Padova, Italy.
Reprod Biomed Online. 2015 Jul;31(1):100-7. doi: 10.1016/j.rbmo.2015.03.009. Epub 2015 Apr 8.
Sperm DNA status has been reported to predict fertility outcomes in infertile men. The terminal deoxynucleotidyl transferase-mediated dUDP nick-end labelling test (TUNEL) is the most widely used method to evaluate this; however, its prognostic value is still debated. One hundred infertile men undergoing intracytoplasmic sperm injection (ICSI) and 61 fertile men were tested for sperm parameters, sex hormones and sperm DNA status by chromatin tests (acridine orange, aniline blue, decondensation) and by direct assays (TUNEL and phosphorylated histone H2AX-γH2AX). In both groups, the prognostic value of each parameter to predict assisted clinical pregnancy was compared. Sperm parameters (P < 0.05 or P < 0.01), FSH levels (P < 0.05) and DNA status (P < 0.05 to P < 0.001) were significantly different in participants compared with controls. Among infertile men, 47 had positive and 53 had ICSI outcome. Both chromatin analysis and TUNEL test were unable to distinguish individuals who had successful outcomes from those who failed ICSI treatments. γH2AX percentage and γH2AX fragmentation index were significantly higher in sperm from non-pregnant compared with pregnant couples (P < 0.05 and P < 0.01). γH2AX assay is more predictive of ICSI outcome than TUNEL in infertile couples with male factor infertility.
据报道，精子DNA状态可预测不育男性的生育结果。末端脱氧核苷酸转移酶介导的dUDP缺口末端标记试验（TUNEL）是评估这一指标最常用的方法；然而，其预后价值仍存在争议。对100名接受卵胞浆内单精子注射（ICSI）的不育男性和61名生育男性进行了精子参数、性激素和精子DNA状态检测，检测方法包括染色质检测（吖啶橙、苯胺蓝、解聚）和直接检测（TUNEL和磷酸化组蛋白H2AX-γH2AX）。在两组中，比较了各参数对预测辅助临床妊娠的预后价值。与对照组相比，参与者的精子参数（P<0.05或P<0.01）、卵泡刺激素水平（P<0.05）和DNA状态（P<0.05至P<0.001）存在显著差异。在不育男性中，47人ICSI结果为阳性，53人ICSI结果为阴性。染色质分析和TUNEL试验均无法区分ICSI治疗成功和失败的个体。与妊娠夫妇相比，未妊娠夫妇精子中的γH2AX百分比和γH2AX片段化指数显著更高（P<0.05和P<0.01）。在男性因素不育的不育夫妇中，γH2AX检测比TUNEL更能预测ICSI结果。
