|
 |
精液诊断测试
谁需要特别精液诊断测试?
- 多次宫腔内人工授精失败
- 多次试管受精失败
- 不明原因不孕
- 超过40岁的男士精液单个参数异常。例如:严重畸形 (正常形态<1%) 或弱精症 (前向运动<20%) 或精液中大量圆形细胞 > 5%
- 男士泌尿、生殖系统重复感染
- 惯性流产
1. 精子脱氧核糖核酸碎片含量测试 (Sperm DNA Fragmentation Assay)
- 精子的细胞核和脱氧核糖核酸的完整性是与卵子受精和胚胎的发育相关的
- 此测试能够分辨出具有完整脱氧核糖核酸的精子及有脱氧核糖核酸残碎的精子
- 精子脱氧核糖核酸碎片指数(SDF)能够预测宫腔内人工授精妊娠结果。当SDF值大过30%时,成功怀孕至生育的机会从19.0%显著降至到1.5%。SDF值大过30%的夫妇应直接接受试管婴儿治疗程序。利用体外受孕(IVF)或单精子卵浆内注射(ICSI),可显著提高怀孕机会。我们亦建议利用physiological ICSI (PICSI)来增加怀孕的机会。PICSI使用透明质酸为化学因子能吸引成熟和形态正常的精子作单精子卵浆内注射(ICSI)
2. 精子透明质酸结合分析 (Sperm Hyaluronan Binding Assay)
- 透明质酸是包围在卵母细胞周围的卵丘细胞的主要成分,在自然受精过程中,它作为一个化学因子吸引精子,并诱发精子的超活化
- 只有成熟的精子才能够结合到透明质酸和卵子透明带,精子与透明质酸结合的数量是一个指标,可以确定精子的成熟和生理功能
- 透明质酸结合分析是一个独特的方法,对于怀疑不育的男士可以用此方法预测精子对卵子的受精能力
参考资料︰
- Ahmadi, A and Ng SC. 1999. Developmental capacity of damaged spermatozoa. Human Reprod. 14:2279-2285.
- Bungum M, Humaldan P, Axmon A., et al. 2007. Sperm DNA integrity assessment in prediction of assisted reproduction technology outcome. Human Reproduction. 22(1): 174-179.
- Breznik Pregl B, Kovacic B, Vlaisavljevic V. 2013. Are sperm DNA fragmentation, hyperactivation, and hyaluronan binding ability predictive for fertilization and embryo development in in vitro fertilization and intracytoplasmic sperm injection? Fertil Steril. 99(5):1233-41.
- Huszar G. 2012. Sperm testing and ICSI selection by hyaluronic acid binding: the hyaluronic acid coated glass slide and petri dish in the andrology and IVF laboratories. Practical manual of in vitro fertilization: advanced methods and novel devices. New York: Springer. 241-257.
- Worilow K.C, Eid S, Woodhouse D., et al. (2013). Use of hyaluron in selection of sperm for ICSI; a significant improvement in clinical outcomes-multicentre, double-blind randomised trial. Hum Reprod; 28(2): 306–314
- Yagci Artay, Murk William, Stronk Jill., et al. 2010. Spermatozoa bound to solid state hyaluronic acid show chromatin structure with high DNA chain integrity: an acridine orange fluorescence study. Journal of Andrology. 31(6):566-572.
|