目的:本研究的目的是分析患有多种精子鞭毛形态异常(MMAF)的中国男性的精子形态,并观察胞浆内单精子注射(ICSI)的结局。
方法:一名中国男子通过精液分析和电子显微镜诊断为精子鞭毛的多种形态异常。睾丸精子胞浆内注射,并观察到以下ICSI结果。
结果:他射精的所有精子在鞭毛中都不运动且形态异常。在透射电子显微镜检测中,大多数精子表现出杂乱无章的纤维鞘,伴随着各种细胞骨架成分的变形,缺少中央对微管。睾丸精子在两个ICSI周期中注射到卵母细胞中,受精率分别为45.5和40.0%。最后,在第二个ICSI周期分娩了一名健康的女婴.
结论:卵胞浆内单精子注射可以实现受精和妊娠,不管严重的鞭毛缺陷。ICSI对MMAF患者有效,当没有活动精子时,睾丸精子是一种选择。
OBJECTIVE: The purpose of this study is to analyze the sperm morphology of a Chinese man affected with multiple morphological abnormalities of the sperm flagella (MMAF) and observe the intracytoplasmic sperm injection (ICSI) outcome.
METHODS: A Chinese man was diagnosed with multiple morphological abnormalities of the sperm flagella by semen analysis and electron microscopy. Testicular spermatozoa were injected intracytoplasmically, and the following ICSI results were observed.
RESULTS: All the spermatozoa from his ejaculate were immotile and morphologically abnormal in the flagellum. In transmission electron microscopy assays, most spermatozoa showed disorganized fibrous sheath, accompanied by distortion of various cytoskeletal components, and missing of the central pair microtubules. Testicular sperm was injected to the oocytes in two ICSI cycles, with fertilization rates of 45.5 and 40.0%. Finally, a healthy female infant was delivered at the second ICSI cycle.
CONCLUSIONS: Fertilization and pregnancy could be achieved by intracytoplasmic sperm injection, regardless of severe flagellar defects. ICSI is effective for MMAF-affected man, and testicular sperm is an alternative when no motile sperm is available.