Sha Y-W, Ding L, Wu J-X, Lin S-B, Wang X, Ji Z-Y, Li P
Reproductive Medicine Center, Maternal and Child Health Hospital of Xiamen City, Xiamen, China.
Laboratory of Reproductive Medicine, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, China.
Andrologia. 2017 Oct;49(8). doi: 10.1111/and.12716. Epub 2016 Oct 6.
Spermatozoa morphology, an important parameter in a semen specimen's potential fertility evaluation, is a significant factor for in vitro fertilisation in assisted reproductive technology. Eleven sterile men with headless spermatozoa, a type of human teratozoospermia, are presented. Their ejaculates' headless spermatozoa percentages were high with rare normal spermatozoa forms. Additionally, abnormal morphology (e.g. round-headed or microcephalic spermatozoa) was also found. Spermatozoa motility was somewhat affected, potentially because of the missing mitochondrial sheath at the sperm tail base. Patients who underwent assisted reproductive technology treatment experienced adverse pregnancy outcomes. Work types and corresponding environments seemed irrelevant, but specific family history may have prompted its genetic origin. Computer-assisted semen analysis systems easily mistake headless spermatozoa as oligozoospermia because of nonrecognition of the loose head. However, morphological testing, especially with an electronic microscope, clearly identifies abnormal spermatozoa. Future exploration requires more methods investigating the frequency and percentage of this morphological abnormality in different populations with varied fertility levels. Such research would estimate the probable correlation of the abnormality with other semen parameters and examine the potential developmental or genetic origins. During clinical work, medical staff should detect these cases, avoid misdiagnosis and provide proper consultation about diagnosis and assisted reproductive technology treatment.
精子形态是精液标本潜在生育能力评估中的一个重要参数，是辅助生殖技术中体外受精的一个重要因素。本文介绍了11例患有无头精子症（一种人类畸形精子症）的不育男性。他们射精中的无头精子百分比很高，正常精子形态罕见。此外，还发现了异常形态（如圆头或小头精子）。精子活力受到一定影响，可能是因为精子尾部基部缺少线粒体鞘。接受辅助生殖技术治疗的患者出现了不良妊娠结局。工作类型和相应环境似乎无关，但特定的家族史可能提示了其遗传起源。计算机辅助精液分析系统由于无法识别松散的头部，容易将无头精子误判为少精子症。然而，形态学检测，尤其是电子显微镜检测，能够清晰地识别异常精子。未来的探索需要更多方法来研究不同生育水平人群中这种形态异常的频率和百分比。此类研究将估计该异常与其他精液参数的可能相关性，并研究其潜在的发育或遗传起源。在临床工作中，医务人员应检测出这些病例，避免误诊，并提供有关诊断和辅助生殖技术治疗的适当咨询。
