The Ronald O. Perelman and Claudia Cohen Center for Reproductive MedicineWeill Cornell Medicine, New York, New York, USA
The Ronald O. Perelman and Claudia Cohen Center for Reproductive MedicineWeill Cornell Medicine, New York, New York, USA.
Reproduction. 2017 Dec;154(6):F93-F110. doi: 10.1530/REP-17-0374. Epub 2017 Nov 20.
Among infertile couples, 25% involve both male and female factors, while male factor alone accounts for another 25% due to oligo-, astheno-, teratozoospermia, a combination of the three, or even a complete absence of sperm cells in the ejaculate and can lead to a poor prognosis even with the help of assisted reproductive technology (ART). Intracytoplasmic sperm injection (ICSI) has been with us now for a quarter of a century and in spite of the controversy generated since its inception, it remains in the forefront of the techniques utilized in ART. The development of ICSI in 1992 has drastically decreased the impact of male factor, resulting in millions of pregnancies worldwide for couples who, without ICSI, would have had little chance of having their own biological child. This review focuses on the state of the art of ICSI regarding utility of bioassays that evaluate male factor infertility beyond the standard semen analysis and describes the current application and advances in regard to ICSI, particularly the genetic and epigenetic characteristics of spermatozoa and their impact on reproductive outcome.
在不孕夫妇中，25%涉及男女双方因素，而由于少精症、弱精症、畸形精症、三者的组合，甚至精液中完全没有精子细胞，导致即使借助辅助生殖技术（ART）也预后不良，这种情况占 25%。胞浆内单精子注射（ICSI）已经问世四分之一世纪了，尽管自成立以来一直存在争议，但它仍然是 ART 中应用技术的前沿。1992 年 ICSI 的发展极大地降低了男性因素的影响，为数百万对夫妇带来了妊娠，而如果没有 ICSI，这些夫妇几乎没有机会拥有自己的亲生子女。这篇综述重点介绍了 ICSI 在超越标准精液分析评估男性因素不育方面的最新技术状态，并描述了目前在 ICSI 方面的应用和进展，特别是精子的遗传和表观遗传特征及其对生殖结局的影响。
