Diagnosis and Treatment of Male Infertility-Related Fertilization Failure.
Diagnosis and Treatment of Male Infertility-Related Fertilization Failure.
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DOI：
10.3390/jcm9123899
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发表时间：
2020-12-01
影响因子：
3.9
通讯作者：
Heindryckx B
中科院分区：
文献类型：
--
作者：
Cardona Barberán A;Boel A;Vanden Meerschaut F;Stoop D;Heindryckx B
全球约 15% 的育龄夫妇患有不孕症，其中高达 30% 的病例仅由男性因素引起。男性不育的根源大多归因于精子异常，其中很多是由基因缺陷引起的。胞浆内单精子注射 (ICSI) 的发展有助于避免大多数男性不育症。然而，仍然存在一个具有挑战性的不育男性群体，他们的精子虽然具有正常的精子参数，但即使在 ICSI 治疗后也无法激活卵母细胞。虽然 ICSI 通常允许 70% 至 80% 的受精率，但在 ICSI 周期中仍有 1% 至 3% 发生完全受精失败 (FF)。磷脂酶 C zeta (PLCz) 已被证明是一种关键的精子卵母细胞激活因子 (SOAF)，PLCz 的缺失、减少或形式改变已被证明会导致男性不育相关的 FF。本综述的目的是 (i) 总结目前关于 PLC z 作为成功受精的关键精子因素的知识，并讨论替代精子诱导卵母细胞激活机制的存在，(ii) 描述可用于确定 FF 原因的诊断测试，以及 (iii) 总结辅助卵母细胞激活 (AOA) 对克服 FF 的有益作用。
Infertility affects approximately 15% of reproductive-aged couples worldwide, of which up to 30% of the cases are caused by male factors alone. The origin of male infertility is mostly attributed to sperm abnormalities, of which many are caused by genetic defects. The development of intracytoplasmic sperm injection (ICSI) has helped to circumvent most male infertility conditions. However, there is still a challenging group of infertile males whose sperm, although having normal sperm parameters, are unable to activate the oocyte, even after ICSI treatment. While ICSI generally allows fertilization rates of 70 to 80%, total fertilization failure (FF) still occurs in 1 to 3% of ICSI cycles. Phospholipase C zeta (PLCζ) has been demonstrated to be a critical sperm oocyte activating factor (SOAF) and the absence, reduced, or altered forms of PLCζ have been shown to cause male infertility-related FF. The purpose of this review is to (i) summarize the current knowledge on PLCζ as the critical sperm factor for successful fertilization, as well as to discuss the existence of alternative sperm-induced oocyte activation mechanisms, (ii) describe the diagnostic tests available to determine the cause of FF, and (iii) summarize the beneficial effect of assisted oocyte activation (AOA) to overcome FF.
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