应用睾丸精子行卵胞浆内单精子注射成功：附 1 例多发精子鞭毛形态异常患者报告。
Successful intracytoplasmic sperm injection with testicular spermatozoa from a man with multiple morphological abnormalities of the sperm flagella: a case report.
机构信息
Center for Reproduction and Genetics, Suzhou Hospital Affiliated to Nanjing Medical University, Suzhou, 215002, China.
出版信息
J Assist Reprod Genet. 2018 Feb;35(2):247-250. doi: 10.1007/s10815-017-1057-5. Epub 2017 Oct 2.
PURPOSE
The purpose of this study is to analyze the sperm morphology of a Chinese man affected with multiple morphological abnormalities of the sperm flagella (MMAF) and observe the intracytoplasmic sperm injection (ICSI) outcome.
METHODS
A Chinese man was diagnosed with multiple morphological abnormalities of the sperm flagella by semen analysis and electron microscopy. Testicular spermatozoa were injected intracytoplasmically, and the following ICSI results were observed.
RESULTS
All the spermatozoa from his ejaculate were immotile and morphologically abnormal in the flagellum. In transmission electron microscopy assays, most spermatozoa showed disorganized fibrous sheath, accompanied by distortion of various cytoskeletal components, and missing of the central pair microtubules. Testicular sperm was injected to the oocytes in two ICSI cycles, with fertilization rates of 45.5 and 40.0%. Finally, a healthy female infant was delivered at the second ICSI cycle.
CONCLUSIONS
Fertilization and pregnancy could be achieved by intracytoplasmic sperm injection, regardless of severe flagellar defects. ICSI is effective for MMAF-affected man, and testicular sperm is an alternative when no motile sperm is available.
目的
本研究旨在分析一名患有多种精子鞭毛形态异常（MMAF）的中国男性的精子形态，并观察其胞质内单精子注射（ICSI）的结果。
方法
一名中国男性通过精液分析和电子显微镜检查被诊断为多种精子鞭毛形态异常。对睾丸精子进行胞质内注射，并观察以下 ICSI 结果。
结果
他的精液中的所有精子均不动且鞭毛形态异常。在透射电子显微镜检测中，大多数精子显示纤维鞘排列紊乱，伴有各种细胞骨架成分的扭曲，以及中央对微管的缺失。在两个 ICSI 周期中，将睾丸精子注入卵母细胞，受精率分别为 45.5%和 40.0%。最终，在第二次 ICSI 周期中成功分娩了一名健康女婴。
结论
无论鞭毛缺陷严重程度如何，胞质内单精子注射均可实现受精和妊娠。ICSI 对 MMAF 患者有效，并且在没有活动精子时，睾丸精子是一种替代方案。
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