Ronald O. Perelman and Claudia Cohen Center for Reproductive MedicineWeill Cornell Medical College, New York, New York, USA
Ronald O. Perelman and Claudia Cohen Center for Reproductive MedicineWeill Cornell Medical College, New York, New York, USA.
Reproduction. 2017 Dec;154(6):F71-F77. doi: 10.1530/REP-17-0308. Epub 2017 Oct 18.
Intracytoplasmic sperm injection (ICSI) has often been heralded as a ground-breaking technique that has transformed the treatment of couples with infertility. By injecting a single spermatozoon into the cytoplasm of the oocyte, ICSI bypasses the zona pellucida and increases the chances of fertilization and subsequent embryo development, independent of semen parameters. Ever since the first live births using ICSI were reported in 1992, ICSI has become the mainstay of treating male factor infertility as well as overcoming fertilization failure associated with conventional insemination. Today, ICSI is utilized in nearly 66% of all assisted reproductive treatments worldwide and has resulted in the birth of millions of babies. The primary goal of this review is to provide historical perspectives about the pioneering of ICSI. We begin by highlighting the scientific work of early investigators who elucidated the mechanisms central to mammalian fertilization. Furthermore, we briefly discuss how these findings contributed to the development of IVF for the treatment of infertility. We then emphasize the shortcomings of IVF in treating severe forms of male factor infertility and enumerate the micromanipulation techniques that were developed to circumvent these shortcomings. Finally, we indicate how the inadequacies of these micromanipulation techniques lead to the inception, application and popularity of ICSI.
胞浆内单精子注射（ICSI）常被誉为一项突破性技术，它改变了不孕夫妇的治疗方式。通过将单个精子注入卵母细胞的细胞质，ICSI 绕过了透明带，增加了受精和随后胚胎发育的机会，而不受精液参数的影响。自 1992 年首次报道使用 ICSI 进行活产以来，ICSI 已成为治疗男性因素不孕以及克服与常规授精相关的受精失败的主要手段。如今，ICSI 已在全球近 66%的辅助生殖治疗中得到应用，为数百万婴儿的诞生做出了贡献。本文的主要目的是提供 ICSI 开拓性研究的历史观点。我们首先强调早期研究人员的科学工作，这些工作阐明了哺乳动物受精的核心机制。此外，我们简要讨论了这些发现如何为治疗不孕的体外受精（IVF）的发展做出贡献。然后，我们强调 IVF 在治疗严重男性因素不孕方面的局限性，并列举了为克服这些局限性而开发的微操作技术。最后，我们指出这些微操作技术的不足如何导致 ICSI 的产生、应用和普及。
