Bieniek Jared M, Lo Kirk C
Department of Urology, Hartford Hospital, 85 Seymour St., #416, Hartford, CT, 06106, USA.
Division of Urology, Mount Sinai Hospital, University of Toronto, 60 Murray St., 6th floor, Box 19, Toronto, ON, M5T3L9, Canada.
F1000Res. 2016 Nov 24;5:2756. doi: 10.12688/f1000research.9375.1. eCollection 2016.
Male infertility remains a struggle to definitively diagnose and treat with many men labelled as "idiopathic infertility" and eventually requiring assisted reproductive techniques. Along those lines, research groups are continuing to explore current social and environmental factors, including the obesity epidemic, and their effects on male fertility potential. Novel biomarkers of natural fertility status and azoospermia etiology have additionally seen recent attention with ACRV1 and TEX101/ECM1 assays either currently or soon to be commercially available. Despite these advancements, however, medical treatment options have seen little progress. Though surgical therapies have similarly seen little transformation, groups are exploring the use of testicular sperm for couples with elevated sperm DNA fragmentation and either planned or previously failed IVF/ICSI. Concerted collaborative efforts will be needed as we move forward to better understand the challenges men face when struggling to conceive.
男性不育症的明确诊断和治疗仍然困难重重，许多男性被贴上“特发性不育症”的标签，最终需要借助辅助生殖技术。为此，研究团队不断探索当前的社会和环境因素，包括肥胖流行情况及其对男性生育潜力的影响。此外，自然生育状态和无精子症病因的新型生物标志物最近受到关注，ACRV1和TEX101/ECM1检测目前或即将商业化。然而，尽管有这些进展，医学治疗选择进展甚微。虽然手术疗法同样变化不大，但研究团队正在探索为精子DNA碎片化程度较高且计划进行体外受精/卵胞浆内单精子注射（IVF/ICSI）或此前IVF/ICSI失败的夫妇使用睾丸精子。在我们继续前进以更好地理解男性在受孕困难时所面临的挑战时，需要各方齐心协力开展合作。
