Smith Gary D, Cantatore Clementina, Ohl Dana A
Reproductive Sciences Program, Departments of Obstetrics/Gynecology, Physiology, and Urology, University of Michigan, Ann Arbor, MI 48103, USA.
Reproductive and IVF Unit, Department of Maternal and Child Health, Asi Bari, 70014 Conversano (BA), Italy.
J Clin Med. 2021 Aug 19;10(16):3667. doi: 10.3390/jcm10163667.
Intracytoplasmic sperm injection (ICSI) has allowed reproduction options through assisted reproductive technologies (ARTs) for men with no spermatozoa within the ejaculate (azoospermia). In men with non-obstructive azoospermia (NOA), the options for spermatozoa retrieval are testicular sperm extraction (TESE), testicular sperm aspiration (TESA), or micro-surgical sperm extraction (microTESE). At the initial time of spermatozoa removal from the testis, spermatozoa are immobile. Independent of the means of spermatozoa retrieval, the subsequent steps of removing spermatozoa from seminiferous tubules, determining spermatozoa viability, identifying enough spermatozoa for oocyte injections, and isolating viable spermatozoa for injection are currently performed manually by laboratory microscopic dissection and collection. These laboratory techniques are highly labor-intensive, with yield unknown, have an unpredictable efficiency and/or success rate, and are subject to inter-laboratory personnel and intra-laboratory variability. Here, we consider the potential utility, benefits, and shortcomings of developing technologies such as motility induction/stimulants, microfluidics, dielectrophoresis, and cell sorting as andrological laboratory add-ons to reduce the technical burdens and variabilities in viable spermatozoa isolation from testicular samples in men with NOA.
卵胞浆内单精子注射（ICSI）使无精子症（即射出精液中无精子）男性能够通过辅助生殖技术（ART）获得生育选择。对于非梗阻性无精子症（NOA）男性，获取精子的方法有睾丸精子提取（TESE）、睾丸精子抽吸（TESA）或显微外科精子提取（microTESE）。在最初从睾丸中取出精子时，精子是不活动的。无论采用何种精子获取方式，后续从生精小管中取出精子、确定精子活力、识别足够数量用于卵母细胞注射的精子以及分离用于注射的活精子等步骤，目前都是通过实验室显微解剖和收集手动完成的。这些实验室技术劳动强度极大，产量未知，效率和/或成功率不可预测，并且受到实验室间人员差异和实验室内差异的影响。在此，我们探讨诸如运动诱导/刺激剂、微流控技术、介电电泳和细胞分选等新兴技术作为男科学实验室附加手段的潜在效用、益处和缺点，以减轻从NOA男性睾丸样本中分离活精子的技术负担和变异性。
