Aslam I, Fishel S, Green S, Campbell A, Garratt L, McDermott H, Dowell K, Thornton S
CARE Centres for Assisted Reproduction, The Park Hospital, Arnold, Nottingham, UK.
Hum Reprod Update. 1998 May-Jun;4(3):213-22. doi: 10.1093/humupd/4.3.213.
During 1995 and 1996 the first spermatid pregnancies were announced with both round spermatid (ROSI) and elongated spermatid (ELSI) injections. These publications were flanked by live births from ROSI in a number of animal species, with resulting offspring appearing normal, healthy and fertile. However, the live births in humans heralded a scientific and ethical debate on the clinical use of this technology; and in a number of countries nationwide moratoria prohibiting spermatid microinjection were enjoined. Concerns surrounded the biological condition of spermatids and clinical implications of utilizing an immature spermatozoon for conception. Nevertheless, case reports and a few scientific studies on human spermatid conception have been published in recent years, and further polemic on testicular histopathology and prognosis has ensued. This paper reviews the current arguments on the clinical use of ROSI and ELSI, and evaluates the biology of the main contributory components of a spermatozoon to the subsequent embryo, namely the genetic material, the microtubular organizing complex and the putative oocyte activating factor. We also consider the relevant testicular histopathology and likely outcome in the context of the current birth rate from ROSI and ICSI. We conclude by considering the way forward for infertile men who require this technology to become genetic fathers, and whether the time is now appropriate to consider clinical trials.
1995年至1996年期间，首次宣布了通过注射圆形精子细胞（ROSI）和长形精子细胞（ELSI）实现的精子细胞妊娠。这些报道的前后，许多动物物种通过ROSI实现了活体分娩，所产后代看起来正常、健康且具有生育能力。然而，人类的活体分娩引发了关于这项技术临床应用的科学和伦理辩论；在一些国家，全国范围内禁止精子细胞显微注射的禁令被颁布。人们担心精子细胞的生物学状况以及利用未成熟精子进行受孕的临床影响。尽管如此，近年来已经发表了关于人类精子细胞受孕的病例报告和一些科学研究，随之而来的是关于睾丸组织病理学和预后的进一步争论。本文回顾了当前关于ROSI和ELSI临床应用的争论，并评估了精子对后续胚胎的主要组成部分的生物学特性，即遗传物质、微管组织复合体和假定的卵母细胞激活因子。我们还结合当前ROSI和ICSI的出生率情况，考虑了相关的睾丸组织病理学和可能的结果。我们通过考虑那些需要这项技术成为遗传父亲的不育男性的未来之路，以及现在是否适合考虑进行临床试验来得出结论。
