Tanaka Atsushi, Nagayoshi Motoi, Takemoto Youichi, Tanaka Izumi, Kusunoki Hiroshi, Watanabe Seiji, Kuroda Keiji, Takeda Satoru, Ito Masahiko, Yanagimachi Ryuzo
Saint Mother Obstetrics and Gynecology Clinic, Institute for ART, Fukuoka 807-0825, Japan;
Faunal Diversity Sciences, Graduate School of Agriculture, Kobe University, Kobe 657-8501, Japan;
Proc Natl Acad Sci U S A. 2015 Nov 24;112(47):14629-34. doi: 10.1073/pnas.1517466112. Epub 2015 Nov 2.
During the human in vitro fertilization procedure in the assisted reproductive technology, intracytoplasmic sperm injection is routinely used to inject a spermatozoon or a less mature elongating spermatid into the oocyte. In some infertile men, round spermatids (haploid male germ cells that have completed meiosis) are the most mature cells visible during testicular biopsy. The microsurgical injection of a round spermatid into an oocyte as a substitute is commonly referred to as round spermatid injection (ROSI). Currently, human ROSI is considered a very inefficient procedure and of no clinical value. Herein, we report the birth and development of 14 children born to 12 women following ROSI of 734 oocytes previously activated by an electric current. The round spermatids came from men who had been diagnosed as not having spermatozoa or elongated spermatids by andrologists at other hospitals after a first Micro-TESE. A key to our success was our ability to identify round spermatids accurately before oocyte injection. As of today, all children born after ROSI in our clinic are without any unusual physical, mental, or epigenetic problems. Thus, for men whose germ cells are unable to develop beyond the round spermatid stage, ROSI can, as a last resort, enable them to have their own genetic offspring.
在辅助生殖技术的人类体外受精过程中，胞浆内单精子注射常用于将一个精子或一个不太成熟的延长型精子细胞注入卵母细胞。在一些不育男性中，圆形精子细胞（已完成减数分裂的单倍体雄性生殖细胞）是睾丸活检中可见的最成熟细胞。将圆形精子细胞显微注射到卵母细胞中作为替代方法通常称为圆形精子细胞注射（ROSI）。目前，人类ROSI被认为是一种效率非常低且无临床价值的方法。在此，我们报告了734个先前经电流激活的卵母细胞进行ROSI后，12名女性所生的14名儿童的出生和发育情况。圆形精子细胞来自其他医院的男科医生在首次显微睾丸精子提取术后诊断为无精子或延长型精子细胞的男性。我们成功的关键在于在卵母细胞注射前准确识别圆形精子细胞的能力。截至目前，我们诊所ROSI后出生的所有儿童均无任何异常的身体、心理或表观遗传问题。因此，对于生殖细胞无法发育到圆形精子细胞阶段以上的男性，ROSI作为最后的手段，可以使他们拥有自己的遗传后代。
