精蟲稀少病患其精蟲與卵子之結合力或穿透力呈現異常

精蟲過度稀少之病患，
其精蟲與卵子中空透明帶(ZP)結合之能力常呈現異常現象
ZP引發精蟲頭部頂體反應也常呈現異常現象
結論: 精蟲過度稀少之病患，其不孕原因除了數量不足，其精蟲與卵子之結合力異常或穿透力異常可能也是造成不孕之原因，這類病患必須使用ICSI治療

http://humrep.oxfordjournals.org/content/19/2/228.full

High frequency of defective sperm–zona pellucida interaction in oligozoospermic infertile men

1. De Yi Liu1 and 
2. H.W.Gordon Baker

+Author Affiliations

1. University of Melbourne Department of Obstetrics and Gynaecology, Reproductive Services, Royal Women’s Hospital and Melbourne IVF, Victoria 3035, Australia

1. 1To whom correspondence should be addressed. e‐mail: dyl@unimelb.edu.au

• Received May 13, 2003.
• Revision received August 14, 2003.
• Accepted October 18, 2003.

 

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Abstract

BACKGROUND: The ability of sperm to interact with the zona pellucida (ZP) plays a critical role during the process of human fertilization. The aim of this study is to determine frequency of defective sperm–ZP interaction in oligozoospermic infertile men. METHODS: Sperm–ZP binding assays and the ZP‐induced acrosome reaction (AR) were performed in 72 infertile men with a sperm concentration <20×10⁶/ml. Oocytes that had previously failed to fertilize in a clinical IVF programme were used for the tests. Motile sperm (2×10⁶/ml) selected by swim‐up from each semen sample were incubated with four oocytes for 2 h. The number of sperm bound per ZP and the ZP‐induced AR were assessed. Under these conditions, an average of ≤40 sperm bound/ZP was defined as low sperm–ZP binding and a ZP‐induced AR ≤16% was defined as low ZP‐induced AR. RESULTS: In the 72 oligozoospermic men, 28% (20/72) had low sperm–ZP binding. Of those with normal sperm–ZP binding, 69% (36/52) had low ZP‐induced AR. Overall, 78% (56/72) had either low ZP‐binding or normal ZP binding but low ZP‐induced AR. This means that only 22% (16/72) had both normal sperm–ZP binding and normal ZP‐induced AR. CONCLUSION: Oligozoospermic men have a very high frequency of defective sperm–ZP interaction, consistent with their low natural fertility or low fertilization rate in conventional IVF. Infertile couples with oligozoospermic semen should be treated by ICSI rather than by conventional IVF.

High frequency of defective sperm–zona pellucida interaction in oligozoospermic infertile men

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Figure 1. An example for Pisum sativum agglutinin–fluorescein isothiocyanate staining of the acrosome of sperm removed from the surface of zona pellucida. There were five acrosome intact (AI) and four acrosome‐reacted (AR) sperm. The photograph was taken with ×400 magnification.