摘要
目的探讨圆头精子的受精能力、胚胎发育潜能及其遗传风险。方法通过精子形态染色和透射电镜证实一例圆头精子症患者，其女方共获卵26颗，赠卵6颗，将20颗卵子（19颗为MII卵）行卵细胞质内单个圆头精子的显微注射，6颗赠卵行常规体外授精。测定该患者的染色体核型，同时针对Y染色体AZFa、AZFb、AZFc的sY84、sY86、sY127、sY134、sY254、sY255等6个序列标签位点（STS）进行Y染色体微缺失测定。结果19颗MII卵子行圆头精子显微注射后有4颗正常受精并卵裂，其余均未受精和卵裂。6颗赠卵常规体外授精后全部正常受精并卵裂，受精率显著高于圆头精子（100％V821．1％，P〈0．01），卵裂率两者差异无统计学意义（100％vs100％，P〉0．05）。患者染色体核型正常（46，XY），未发现微缺失。女方行冻胚移植后妊娠，足月剖宫产一男孩，染色体核型正常（46，XY）。受者行冻胚移植后妊娠，足月剖宫产一男孩，体健。结论尽管受精率低下，卵细胞质内单精子注射（ICSI）仍不失为治疗圆头精子症患者不育的一种有效方法。
Objective To explore the fertilizing ability, cleavage potential and inheritance risks of globozoospermia. Methods A globozoospermic patient was diagnosed by sperm morphological staining and transmission electron microscope. From his wife the investigators obtained 26 oocytes in which 6 oocytes were donated and the other 19 （in 20） MII oocytes injected into 19 round-headed sperms. Six donated oocytes accepted in vitro fertilization （IVF）. This patients chromosome and microdeletion in AZFa, AZFb and AZFc in Y chromosome were checked through 6 sequence tag sites of sY84, sY86, sY127, sY134, sY254 and sY255. Results Only 4 （ in 19） were normally fertilized and cleaved. All 6 donated oocytes were normally fertilized and cleaved. The fertilizing rate was significantly higher than that of this patient（ 100% vs 21.1% , P 〈0. 01 ）. But the cleavage rate has no statistical difference（ 100% vs 100%, P 〉0. 05）. This patient had normal chromosome （46, XY） and there was no deletion in Y chromosome. His wife became pregnant after accepting two thawed embryos and then gave birth to a boy whose chromosome was normal （46, XY）. The acceptor also gave birth to a healthy boy after accepting two thawed embryos. Conclusions Despite a lower fertilizing rate, intracytoplasmic sperm injection is still an effective therapy for globozoospermic infertility.
出处
《中华医学杂志》
CAS
CSCD
北大核心
2010年第33期2351-2353,共3页
National Medical Journal of China
基金
2009年浙江省人口和计划生育科技项目
关键词
精子
顶体
胚胎发育
Y染色体
染色体缺失
Sperm
Acrosome
Embryo development
Y chromosome
Chromosome deletion
