Meuleman E J, van Moorselaar R J
Academisch Ziekenhuis, afd. Urologie, Nijmegen.
Ned Tijdschr Geneeskd. 1998 Jan 17;142(3):108-11.
In the Netherlands a presumed higher risk of transmission of genetic abnormalities to the offspring in programmes of intracytoplasmatic sperm injection (ICSI) using surgically retrieved sperm (microscopic epididymal sperm aspiration (MESA) or testicular sperm extraction (TESE)) has triggered a moratorium. However, the ICSI-MESA/TESE-programme should be resumed under conditions for the following reasons: the source of the sperm is not a accurate standard of its genetic contents: the cause of the male infertility and the morphology and function of the injected spermatozoon appear to be better criteria; animal experiments and clinical results are reassuring as to the proposed risk; it is uncertain whether the complex genetical mechanisms involved in spermiogenesis and sperm maturation can be unraveled in the laboratory in due course; the exodus of patients to neighbouring countries will be stopped and biological material necessary for human research will become available. The conditions are that (a) only morphologically normal and motile sperm should be used, (b) ICSI should be preceded by genetical screening and succeeded by long term follow up of the offspring.
在荷兰，使用手术获取的精子（显微附睾精子抽吸术（MESA）或睾丸精子提取术（TESE））进行胞浆内单精子注射（ICSI）的程序中，推测向后代传递遗传异常的风险较高，这引发了一项暂停措施。然而，基于以下原因，ICSI-MESA/TESE程序应在一定条件下恢复：精子来源并非其基因内容的准确标准；男性不育的原因以及注入精子的形态和功能似乎是更好的标准；动物实验和临床结果对所提出的风险令人放心；精子发生和精子成熟所涉及的复杂遗传机制能否在实验室中及时阐明尚不确定；患者流向邻国的情况将停止，人类研究所需的生物材料将变得可用。条件是：（a）仅应使用形态正常且有活力的精子，（b）ICSI之前应进行基因筛查，之后应对后代进行长期随访。
