Human Spermatogenesis: Insights From the Clinical Care of Men With Infertility.
Human Spermatogenesis: Insights From the Clinical Care of Men With Infertility.
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DOI：
10.3389/fendo.2022.889959
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发表时间：
2022
影响因子：
5.2
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中科院分区：
文献类型：
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人类精子发生的过程在质量和数量上都与大多数其他哺乳动物所观察到的不同。与大多数其他哺乳动物相比，人类精子发生的特点是产量减少和精子形态更加异常。直到最近，对人类精子产生的直接评估和观察仍然有限，并且大多数有关精子发生的科学知识都来自啮齿动物研究模型。由于治疗严重男性不育症，出现了观察人类精子发生的独特机会。这些患者的精子产量非常有限，以至于没有精子到达射精，因此他们的生育治疗包括从睾丸中取出精子的手术，并结合使用先进的辅助生殖技术来使用这些精子。对患有严重男性不育症的男性的治疗增强了对可能导致这种情况的新遗传异常的识别，因为他们现在正在寻求医疗护理。由此产生了三个关键的新概念：（a）人类男性的精子发生在空间上存在异质性，特别是当精子产生受到损害时；（b）遗传异常在患有严重男性不育症的男性中很常见，特别是在患有弥漫性成熟停滞的男性中；（c）啮齿动物研究可能不是理解人类男性不育症的理想模型。这些临床观察增强了对人类精子发生的科学理解。
Human spermatogenesis is a qualitatively and quantitatively different process than that observed for most other mammals. In contrast with most other mammals, human spermatogenesis is characterized by reduced quantitative production and more abnormal sperm morphology. Until recently, direct evaluation and observations of human sperm production has been limited and the majority of scientific knowledge regarding spermatogenesis was derived from rodent models of study. Unique opportunities to observe human spermatogenesis have occurred as a consequence of the treatment of severe male infertility. These patients have sperm production so limited that no sperm reach the ejaculate so their fertility treatment involves surgical sperm retrieval from the testis, coupled with use of those sperm with advanced assisted reproductive techniques. Treatment of men with severe male infertility has enhanced identification of new genetic abnormalities that may cause this condition, since they now seek medical care. Three key novel concepts have resulted: (a) spermatogenesis is spatially heterogeneous in the human male, especially when sperm production is compromised, (b) genetic abnormalities are common in men with severe male infertility, particularly in men with diffuse maturation arrest and (c) rodent studies may not be an ideal model for understanding human male infertility. Scientific understanding of human spermatogenesis has been enhanced by these clinical observations.