Center for Medical Genetics.
Center for Reproductive Medicine, Universitair Ziekenhuis Brussel, Brussels, Belgium.
Curr Opin Obstet Gynecol. 2019 Jun;31(3):163-169. doi: 10.1097/GCO.0000000000000538.
The impact of intracytoplasmic sperm injection (ICSI), on the reproductive health of the offspring is largely unknown. Here we provide a comprehensive overview of the endocrine and reproductive profile in boys and young male adults born after ICSI using ejaculated spermatozoa alleviating male factor infertility in their parents.
Levels of testosterone, anti-Müllerian hormone and inhibin B were found comparable in prepubertal and pubertal boys conceived by ICSI when compared with levels in boys conceived spontaneously. Also, at young adulthood, mean levels of reproductive hormones did not differ from control peers. However, semen analysis showed significantly lower sperm concentration, total sperm count and total motile sperm count when compared with controls. Furthermore, the risk of having sperm concentration and sperm count below the reference values was increased in ICSI offspring while sperm parameters did not correlate in paired father-son semen analysis.
Although endocrine gonadal function was normal at puberty, exocrine function at young adulthood was not. We observed decreased semen quality and quantity in young adults conceived by ICSI performed to circumvent male factor infertility. The possibility of transgenerational transmission of impaired spermatogenesis after ICSI needs further investigation.
卵胞浆内单精子注射(ICSI)对其后代生殖健康的影响在很大程度上尚不清楚。在这里,我们使用通过 ICSI 出生的可射出精子来治疗其父母的男性因素不育,为大家提供了一个关于使用 ICSI 出生的男孩和年轻男性成年人的内分泌和生殖特征的全面概述。
与自然受孕的男孩相比,ICSI 受孕的青春期前和青春期男孩的睾酮、抗苗勒管激素和抑制素 B 水平相当。此外,在成年早期,生殖激素的平均水平与对照同龄人没有差异。然而,与对照组相比,精液分析显示精子浓度、总精子数和总活动精子数显著降低。此外,ICSI 后代的精子浓度和精子计数低于参考值的风险增加,而在配对的父子精液分析中,精子参数没有相关性。
尽管青春期时性腺内分泌功能正常,但成年早期的外分泌功能却不正常。我们观察到,通过 ICSI 治疗男性因素不育而出生的年轻人的精液质量和数量下降。ICSI 后精子发生受损的跨代传递的可能性需要进一步研究。