Department of Surgery (Urology), University of Utah School of Medicine, Salt Lake City, UT, USA.
Department of Surgery (Urology), University of Utah School of Medicine, Salt Lake City, UT, USA.
Best Pract Res Clin Obstet Gynaecol. 2017 Oct;44:38-56. doi: 10.1016/j.bpobgyn.2017.07.003. Epub 2017 Aug 2.
Sperm nuclear and chromatin abnormalities are common among infertile men and are known to influence natural reproduction. These abnormalities are also considered detrimental to normal fertilization, embryo development, and successful implantation and pregnancies following assisted reproductive treatment (ART). Abnormalities in the sperm nucleus can be broadly classified into sperm chromosomal abnormalities (aneuploidies) and sperm DNA abnormalities such as abnormal packing, DNA integrity, or DNA fragmentation. For the past 30 years, numerous tests have been developed to quantify these abnormalities in sperm. In this chapter, we review the causes of sperm DNA and chromosomal abnormalities, describe the commonly used tests to evaluate these abnormalities, and finally review the impact of these abnormalities on male fertility and ART outcomes. We also performed a comprehensive meta-analysis and systematic review from the existing literature to summarize the effect of sperm DNA fragmentation on ART outcomes such as fertilization rate, embryo quality, and clinical pregnancies. A review of the literature presented in this chapter suggests that sperm nuclear and chromatin abnormalities are associated with male infertility, and they reduce the probability of a successful pregnancy following ART.
精子核和染色质异常在不孕男性中很常见，已知会影响自然生殖。这些异常也被认为对正常受精、胚胎发育以及辅助生殖治疗 (ART) 后的成功着床和妊娠有害。精子核的异常可以大致分为精子染色体异常（非整倍体）和精子 DNA 异常，如异常包装、DNA 完整性或 DNA 片段化。在过去的 30 年中，已经开发出许多测试方法来量化精子中的这些异常。在本章中，我们回顾了精子 DNA 和染色体异常的原因，描述了常用于评估这些异常的测试方法，最后回顾了这些异常对男性生育力和 ART 结果的影响。我们还对现有文献进行了全面的荟萃分析和系统评价，以总结精子 DNA 碎片化对受精率、胚胎质量和临床妊娠等 ART 结果的影响。本章文献综述表明，精子核和染色质异常与男性不育有关，并且降低了 ART 后成功妊娠的概率。
