Jain Manish, Kalsi Amanpreet Kaur, Srivastava Amita, Gupta Yogendra Kumar, Halder Ashutosh
Scientist, Department of Reproductive Biology, All India Institute of Medical Sciences , New Delhi, India .
PhD Student, Department of Reproductive Biology, All India Institute of Medical Sciences , New Delhi, India .
J Clin Diagn Res. 2016 Dec;10(12):RC09-RC13. doi: 10.7860/JCDR/2016/22483.8990. Epub 2016 Dec 1.
Spermiation is a process of releasing sperm into the lumen of seminiferous tubules. Failure in releasing sperm into the lumen is designated as spermiation defect. Spermiation defect cases present as oligo-azoospermia or azoospermia despite normal gonadotropins and testicular histology/cytology. Human spermiation defect never got attention to investigate infertility practice. Most of the information on spermiation defect, so far is from animal experiments. We assume some cases of non-obstructive azoospermia with normal gonadotropins and testicular histology/cytology could be due to spermiation defect.
The aim of the study was to find out the underlying aetiology in cases of human spermiation defect.
A total of 13 cases of spermiation defect and 20 fertile men as control constituted study material. Cases were studied for chromosomal abnormalities by conventional karyotyping, sex chromosome mosaicism by interphase XY FISH, Yq microdeletion by STS PCR, sertoli cell quality (function) and quantity (numbers) by serum Anti-Mullerian Hormone (AMH) and inhibin B besides other hormones like Follicular Stimulating Hormone (FSH), prolactin, testosterone and estradiol. Vitamin A concentration in serum was also measured. Presence of heavy metal was investigated by elemental electron microscopy in seminal cells (eight cases) & by spectrometry in serum as well as seminal plasma.
Chromosomal and Yq microdeletion study failed to detect any abnormalities. AMH, inhibin B and vitamin A were also normal. Estradiol level was high in 6 out of 13 cases (46%) while platinum in seminal cells was high in 4 cases (50%). High (four times or more) serum level of lead and nickel was observed in 11 (85%) and 6 (46%) cases, respectively.
High serum concentration of heavy metals like lead & nickel or high platinum accumulation in seminal cells or high serum estradiol alone or in combinations may be underlying aetiologic factors in human spermiation defect.
精子释放是精子排入生精小管管腔的过程。无法将精子排入管腔被称为精子释放缺陷。精子释放缺陷病例表现为少弱精子症或无精子症，尽管促性腺激素和睾丸组织学/细胞学正常。人类精子释放缺陷在不育症临床实践中从未受到关注。目前，关于精子释放缺陷的大部分信息来自动物实验。我们推测一些促性腺激素和睾丸组织学/细胞学正常的非梗阻性无精子症病例可能是由于精子释放缺陷所致。
本研究旨在找出人类精子释放缺陷病例的潜在病因。
共纳入13例精子释放缺陷病例和20名生育能力正常的男性作为对照组成研究材料。通过常规核型分析研究病例的染色体异常，通过间期XY荧光原位杂交研究性染色体嵌合体，通过序列标签位点聚合酶链反应研究Y染色体微缺失，通过血清抗苗勒管激素（AMH）和抑制素B以及其他激素如促卵泡生成素（FSH）、催乳素、睾酮和雌二醇研究支持细胞的质量（功能）和数量（数目）。还测量了血清中的维生素A浓度。通过精细胞的元素电子显微镜检查（8例）以及血清和精浆中的光谱分析研究重金属的存在情况。
染色体和Y染色体微缺失研究未发现任何异常。AMH、抑制素B和维生素A也均正常。13例中有6例（46%）雌二醇水平升高，4例（50%）精细胞中的铂含量升高。分别在11例（85%）和6例（46%）病例中观察到血清铅和镍水平高（四倍或更高）。
血清中铅和镍等重金属浓度高、精细胞中铂积累高或血清雌二醇单独或联合升高可能是人类精子释放缺陷的潜在病因。
