Wolf J P, Feneux D, Escalier D, Rodrigues D, Frydman R, Jouannet P
Laboratoire de Biologie de la Reproduction et du Développement-Histologie, Embryologie, Cytogénétique, Université Paris XI, Bicêtre, Kremlin Bicêtre, France.
J Reprod Fertil. 1993 Mar;97(2):487-92. doi: 10.1530/jrf.0.0970487.
The absence of outer dynein arms in the sperm flagellum induces an abnormal movement pattern associated with male infertility. These spermatozoa can decondense in zona-free hamster oocytes but result in a very low fertilization rate in in vitro fertilization. We hypothesized that subzonal insemination could help achieve fertilization and pregnancy. A randomized prospective trial (five couples, five cycles) comparing subzonal insemination (n = 31 oocytes) and routine IVF (n = 23 oocytes) was carried out. Oocytes were microinjected with 8.5 +/- 3.6 spermatozoa. In a second series (nine cycles), all the oocytes were microinjected with 10.5 +/- 4.3 spermatozoa. In the randomized series, the fertilization rate was 16.1% without polyploidy, whereas no fertilization was obtained after control IVF insemination. In the second series involving nine couples, six of whom were included in the first series, the fertilization rate increased to 57.8% with a 27.8% polyspermic rate. Eighty-eight per cent of the zygotes cleaved normally (29 out of 33). A total of 11 embryo transfers resulted in three pregnancies, one of which terminated one month later, a second being ongoing and the third delivering a healthy girl. A 21.4% pregnancy rate per cycle, with a 37.5% pregnancy rate per couple, justifies the use of subzonal insemination to treat this particular flagellar dyskinesia.
精子鞭毛中缺少外动力臂会导致与男性不育相关的异常运动模式。这些精子可在无透明带的仓鼠卵母细胞中去浓缩，但在体外受精时受精率极低。我们推测透明带下授精可能有助于实现受精和妊娠。进行了一项随机前瞻性试验（五对夫妇，五个周期），比较透明带下授精（31个卵母细胞）和常规体外受精（23个卵母细胞）。向卵母细胞显微注射8.5±3.6个精子。在第二个系列（九个周期）中，所有卵母细胞均显微注射10.5±4.3个精子。在随机系列中，无多倍体情况下的受精率为16.1%，而对照体外受精授精后未获得受精。在涉及九对夫妇的第二个系列中，其中六对夫妇包含在第一个系列中，受精率提高到57.8%，多精受精率为27.8%。88%的受精卵正常分裂（33个中有29个）。总共11次胚胎移植导致三次妊娠，其中一次在一个月后终止，第二次妊娠仍在进行中，第三次分娩出一名健康女婴。每个周期21.4%的妊娠率，每对夫妇37.5%的妊娠率，证明使用透明带下授精治疗这种特殊的鞭毛运动障碍是合理的。
