罕见圆头精子症患者的临床特征及生育结局观察  

Clinical features and fertility outcomes of rare patients with globozoospermia syndrome

作　　者：韩晓芳[1] 尹海珍 黄翔 刘建荣[1] Han Xiaofang;Yin Haizhen;Huang Xiang;Liu Jianrong(Department of Reproductive Medicine,Shanxi People’s Hospital,Taiyuan 030012,China;Central Laboratory of Shanxi People's Hospital,Taiyuan 030012,China;Reproductive Center of Shanxi Maternal and Child Hospital,Taiyuan 030012,China)

机构地区：[1]山西省人民医院生殖科,太原030012 [2]山西省人民医院中心实验室,太原030012 [3]山西省妇幼保健院生殖中心,太原030012

出　　处：《中国医师杂志》2021年第7期1022-1025,1029,共5页Journal of Chinese Physician

基　　金：山西省卫生健康委科研课题计划项目(2018028);山西省应用基础研究计划项目(201901D111443)。

摘　　要：目的观察圆头精子症患者的临床特征及生育结局。方法收集2016年7月至2020年3月山西省妇幼保健院及山西省人民医院生殖中心5例圆头精子症患者和20例正常健康体检男性信息,其中夫妻中女方均健康,收集男方外周血染色体、AZF基因、精液常规及形态、性激素系列的检测结果,并观察患者配偶单精子显微注射辅助生殖技术结局t结果5例圆头精子症患者不育年限为(4.4±1.8)年,5例患者圆头精子均>95%(其中1例圆头精子率为99%,3例圆头精子率98%,1例圆头精子率96%)。5例圆头精子症患者染色体和AZF基因均正常。圆头精子症患者精子活动率(PR+NP)明显低于健康对照组(P<0.05),性激素,精子数、精子密度、前向运动率(PR)和精子DNA碎片率与健康对照组比较差异无统计学意义(P>0.05)。5例患者配偶均进行了单精子显微注射辅助生殖技术治疗,2例患者配偶怀孕,其中1例患者配偶流产,1例患者配偶单胎。结论圆头精子症患者除了具有圆头精子形态和精子活力低下外,无其他异常表型,辅助生殖技术可能是一种有效的助孕方式。Objective To observe the clinical characteristics and reproductive outcome of patients with globozoospermia syndrome(also called round-headed spermatozoa).Methods The data of 5 patients with round-headed spermatozoa and 20 healthy men in the reproductive center of Shanxi Maternal and Child Hospital and Shanxi Peopled Hospital from July 2016 to March 2020 were collected.Among them,the wife was healthy.The peripheral blood chromosome,AZF gene,semen routine and morphology,sex hormone series were detected for the man,and the outcome of intracytoplasmic sperm injection(ICSI)was observed for the patients.Results The average length of infertility in 5 patients with round-headed sperm was(4.4±1.8)years,and the round-headed sperm rate of 5 patients were all over 95%(including 1 case with round-headed sperm rate of 99%,3 cases with round-headed sperm rate of 98%,and 1 case with round-headed sperm rate of 96%).The chromosome,AZF gene of 5 patients were normal.The sperm motility[progressive motility(FR)rate+non progressive motility(NP)rate]of patients with globozoospermia syndrome was significantly lower than that of the healthy control group(P<0.05).There was no significant difference in sex hormone,sperm count,sperm density,PR(%)and sperm DNA fragmentation rate compared with normal fertility group(P>0.05).All the 5 patients were treated by assisted reproductive technology with ICSI.Two patients were pregnant,including one patient with abortion and one patient with singleton.Conclusions There are no other abnormal phenotypes in patients with round-headed spermatozoa except for the low morphology and motility of round headed spermatozoa.Assisted reproductive technology may be an effective way to assist pregnancy.

关 键 词：精子畸形 圆头精子症 生殖技术 辅助 

分 类 号：R698.2[医药卫生—泌尿科学]