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辅助生殖技术时代不育男性遗传性疾病的基因筛查与治疗进展

Update on genetic screening and treatment for infertile men with genetic disorders in the era of assisted reproductive technology.

作者信息

Lee Seung Ryeol, Lee Tae Ho, Song Seung-Hun, Kim Dong Suk, Choi Kyung Hwa, Lee Jae Ho, Kim Dae Keun

机构信息

Department of Urology, CHA Bundang Medical Center, CHA University, Seongnam, Korea.

Department of Urology, Fertility Center, CHA Gangnam Medical Center, CHA University, Seoul, Korea.

出版信息

Clin Exp Reprod Med. 2021 Dec;48(4):283-294. doi: 10.5653/cerm.2021.04476. Epub 2021 Nov 23.

Abstract

A genetic etiology of male infertility is identified in fewer than 25% of infertile men, while 30% of infertile men lack a clear etiology, resulting in a diagnosis of idiopathic male infertility. Advances in reproductive genetics have provided insights into the mechanisms of male infertility, and a characterization of the genetic basis of male infertility may have broad implications for understanding the causes of infertility and determining the prognosis, optimal treatment, and management of couples. In a substantial proportion of patients with azoospermia, known genetic factors contribute to male infertility. Additionally, the number of identified genetic anomalies in other etiologies of male infertility is growing through advances in whole-genome amplification and next-generation sequencing. In this review, we present an up-to-date overview of the indications for appropriate genetic tests, summarize the characteristics of chromosomal and genetic diseases, and discuss the treatment of couples with genetic infertility by microdissection-testicular sperm extraction, personalized hormone therapy, and in vitro fertilization with pre-implantation genetic testing.

摘要

在不到25%的不育男性中可确定男性不育的遗传病因,而30%的不育男性缺乏明确病因,从而诊断为特发性男性不育。生殖遗传学的进展为男性不育的机制提供了见解,对男性不育遗传基础的特征描述可能对理解不育原因以及确定夫妇的预后、最佳治疗和管理具有广泛意义。在相当一部分无精子症患者中,已知的遗传因素导致男性不育。此外,通过全基因组扩增和下一代测序技术的进步,在男性不育的其他病因中发现的遗传异常数量也在增加。在本综述中,我们提供了适当基因检测适应证的最新概述,总结了染色体和遗传疾病的特征,并讨论了通过显微切割睾丸取精、个性化激素治疗以及植入前基因检测的体外受精对遗传不育夫妇的治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5abf/8651766/1ac5acd9a28d/cerm-2021-04476f1.jpg

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