部分型圆头精子症患者精子超微结构研究  

Sperm ultrastructure in patients with partial globozoospermia

作　　者：刘浩然[1] 杨柳[1] 田慧 冀媛媛 韩晓芳 黄翔 LIU Hao-ran;YANG Liu;TIAN Hui;JI Yuan-yuan;HAN Xiao-fang;HUANG Xiang(Central Laboratory,Shanxi Provincial People's Hospital,Shanxi Medical University,Taiyuan,Shanxi 030012,China;Department of Reproductive Medicine,Fenyang Hospital,Fenyang,Shanxi 032299,China;Center of Reproductive,Maternal and Child Health Hospital of Shanxi Provincial,Taiyuan,Shanxi 030001,China)

机构地区：[1]山西医科大学附属山西省人民医院中心实验室,山西太原030012 [2]汾阳医院生殖医学科,山西汾阳032299 [3]山西省妇幼保健院生殖中心,山西太原030001

出　　处：《中华男科学杂志》2024年第10期867-871,共5页National Journal of Andrology

基　　金：国家自然科学基金青年基金项目(82101689)。

摘　　要：目的:探讨部分型圆头精子患者中圆头精子和正常精子形态与超微结构差异及辅助生殖结局。方法:收集2023年3月至2024年3月山西省妇幼保健院及山西省人民医院生殖中心6例确诊为部分型圆头精子症患者的临床信息及精液样本,对样本行Diff-Quik染色、铀铅染色,在光学显微镜和透射电子显微镜下观察精子形态,对比圆头精子与正常精子的超微结构区别,分析临床治疗结局。结果:光学显微镜下正常精子头部形态规则,为光滑的椭圆形,顶体区域清晰可见,头、尾部衔接流畅;圆头精子头部无顶体结构,呈圆形,可伴有尾部异常;透射电子显微镜下正常精子头部质膜完整,顶体发育正常,尾部轴丝微管排列整齐;圆头精子头部质膜溶解、顶体缺失或小顶体、核质颗粒化、核区巨大空泡,颈部线粒体肿胀、缺失、排列紊乱,尾部“9+2”微管结构排列混乱且缺失。6例部分型圆头精子症患者均接受了卵细胞胞质内单精子注射(ICSI)助孕治疗,其中1例获得妊娠结局。结论:通过形态学分析,对比正常精子与圆头精子的超微结构差异,部分型圆头精子患者其精子细胞器结构存在显著损伤和超微结构异常,可能是导致其不育问题的一个关键因素,ICSI可以帮助部分圆头精子症患者实现生育愿望。Objective:To investigate the morphological and ultrastructural differences between normal and round-headed sperm and the outcomes of assisted reproduction in patients with partial globozoospermia.Methods:We collected clinical information and semen samples from 6 cases of partial globozoospermia confirmed in our hosptials from March 2023 to March 2024,performed Diff-Quik staining of the samples,observed the sperm morphology under the light microscope and transmission electron microscope,compared the ultrastructures between round-headed and normal spermatozoa,and analyzed the clinical outcomes of assisted reproduction in the patients.Results:Under the light microscope,the the round-headed sperm had no acrosomal structure,some with tail abnormalities;while under the transmission electron microscope,they exhibited dissolved plasma membrane,acrosomal absence,small acrosomes,nucleoplasmic granulation,huge central vacuoles,swelling,absence or irregular arrangement of mitochondria in the neck,and disorganized or missed 9+2 microtubules in the tail.All the 6 patients underwent intracytoplasmic sperm injection(ICSI),and 1 of them achieved pregnancy.Conclusion:The sperm organelle is morphologically damaged and ultrastructurally abnormal in some patients with partial globozoospermia,which may be a key factor for their infertility,and ICSI can help some of them to achieve fertility.

关 键 词：圆头精子 精子形态 超微结构 透射电子显微镜 卵细胞胞质内单精子注射 

分 类 号：R698.2[医药卫生—泌尿科学]