国际生殖健康/计划生育 ›› 2010, Vol. 29 ›› Issue (3): 182-187.

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21 世纪医学的精液分析:精子功能检测的必要性

Lamb DJ   

  1. Scott Department of Urology and the Department of Molecular and Cellular Biology,Baylor College of Medicine,Houston,TX 77030,USA
  • 收稿日期:1900-01-01 修回日期:1900-01-01 出版日期:2010-05-15 发布日期:2010-05-15

Semen Analysis in 21st Century Medicine: the Need for Sperm Function Testing

Lamb DJ   

  1. Scott Department of Urology and the Department of Molecular and Cellular Biology,Baylor College of Medicine,Houston,TX 77030,USA
  • Received:1900-01-01 Revised:1900-01-01 Published:2010-05-15 Online:2010-05-15

摘要: 精子功能检测曾经是不孕夫妇进行辅助生殖技术(ART)前普遍采取的检查。如今世界各地的生殖医学中心已忽视了这些检查。精子功能检测操作步骤的确已分组纳入最新出版的《世界卫生组
织人类精液分析实验室技术手册》的“研究步骤”章节。这很大程度上反映了此现状,即当前临床实践忽略了对不孕夫妇中男方因素的深入检查。认为如果能找到精子,一定就是健康、具有受精能力的、可进行胞浆内单精子注射(ICSI)的精子。然而,通过精子功能测试,可揭示造成男性不育的精子缺陷,为不孕夫妇提供指导。诚然,在某些情况下,ART可克服某些精子功能缺陷,但在其他情况下,夫妇有权了解不孕不育的原因,甚至ICSI 的成功率(和精子有关)。知晓这些,有助于其真正清楚自己的生育状态,以证实是否寻求供精人工授精、领养孩子或维持无子女状态。了解不孕的真正原因,有助于说服不孕夫妇放弃艰难又毫无结果的自然妊娠,更加坚定地选择ART 治疗不育。

关键词: 精液分析, 精子功能测试, 辅助生殖技术

Abstract: Sperm function testing,once commonly performed for the infertile couple before employing assisted reproductive technology (ART),has fallen out of favour in many reproductive medicine centers throughout the world. Indeed,the most recent addition of the“World Health Organisation(WHO)Laboratory Manual for the Examination and Processing of Human Semen”now groups many of these procedures into a section termed Research Procedures. In large part,this reflects the current clinical practice of bypassing the in-depth evaluation of the male partner,while assuming that if a spermatozoon can be found for intracytoplasmic sperm injection (ICSI), it must be a healthy cell capable of achieving fertilization. Nevertheless,sperm function testing can provide valuable clinical insights into defects causing male infertility. Admittedly,in some cases,functional sperm deficiencies can be overcome using an ART. In other cases,couples will be empowered by the knowledge of the cause of their infertility,and for some couples,perhaps even the likelihood of ICSI success(relative to the spermatozoa). The knowledge allows them to make truly informed reproductive decisions,including(perhaps)the decision to seek donor insemination,to adopt or to remain childless. Knowledge of the cause of their infertility may provide closure for couples and a sense of confidence regarding their choice of reproductive treatment.

Key words: Semen analysis, Sperm function tests, Assisted reproductive technology