辅助生殖中外科取精术所获精子的处理与选择

卵胞浆内单精子注射技术(ICSI)已成为帮助男性不育患者获得后代的一项革命性技术,对于无精子症患者,外科取精术能帮助获得精子,但是如何有效处理组织且选择具有受精潜力的精子是目前面临的挑战之一。本文综述了目前外科常用的5种选取活的不动精子的技术方法(包括机械接触技术、低渗肿胀试验、化学活性增强剂、激光辅助不动精子选择及双折射偏振显微镜),并分析了其在临床应用和实验室研究方向中的发展动态,将胚胎干细胞或诱导多能干细胞在体外诱导生成精子可能成为未来的发展方向,但尚存在诸多尚未解决的生物学问题和安全性及伦理问题。

Processing and selecting sperm obtained from surgery in ART

Intracytoplasmic sperm injection(ICSI)has been a revolutionary technology to solve male infertility.Surgical sperm extraction can obtain sperm in the patients with azoospermia.How to effectively deal with testicular tissue and select sperm with fertilization potential is one of the challenges at present.This paper reviewed five methods of selection of living sperm,including mechanical touch technique,hypotonic swelling test,chemical active enhancer,laser-assisted sperm selection and birefringent polarization microscope,and analyzed its development trends in clinical application and laboratory research.It may be the future development direction to induce spermatogenesis from embryonic stem cells or induce pluripotent stem cells in vitro,but there are still many unresolved biological and safety and ethical issues.