关于精子DNA断裂,泌尿科医生应该知道些什么

Yu. V. Olefir, E. A. Efremov, M. A. Rodionov, A. R. Zhuvilko, D. M. Popov, D. M. Monakov
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摘要

背景。精子图仍然是诊断男性不育症的主要实验室方法之一,但正常的精子图并不能保证患者的生育能力。更重要的是,在10 - 30%的病例中,它不能让我们找到不孕的原因。精子DNA片段化(SDF)研究是解决这一问题的可能途径。将目前可获得的关于SDF的临床意义、病因、诊断和治疗方法的信息系统化,供泌尿科医生在日常实践中使用。材料和方法。检索数据库中的出版物,检索关键词为:男性不育、精子DNA断裂、病因、原因、精索静脉曲张、氧化应激、诊断、治疗。本综述共纳入了111项研究。酒精、烟草、麻醉品、心理情绪压力、不利的环境因素和职业中毒、生殖系统感染和炎症、精索静脉曲张和父亲年龄的增加可导致SDF增加和不利的生殖结果,无论是自然怀孕还是使用辅助生殖技术。关于代谢综合征在SDF发生中的作用的数据是模棱两可的。氧化应激是精子DNA损伤的主要机制。SDF水平可以用直接(Comet, TUNEL)和间接(SDS, SCSA)方法来估计。SDF的治疗旨在消除有害因素,对抗氧化应激和重组促卵泡激素的使用。SDF水平是评估男性生殖潜能和预测各种克服不育症方法成功的重要指标。最近,在生殖医学领域的专家的临床实践中,已经扩大了使用评估精子遗传物质完整性的方法的适应症。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
What should urologist know about sperm DNA fragmentation
Background. Spermogram remains one of the main laboratory methods of male infertility diagnosis, but normal spermogram do not guarantee the patient’s fertility. More over, it does not allow us to find out the cause of infertility in 10–30 % cases. The sperm DNA fragmentation (SDF) studying is a possible solution to this problem.Aim. To systematize the currently available information about of clinical significance, causes, methods of diagnosis and treatment of SDF to be used by an urologist in rutine practice.Materials and methods. The search of publications in databases was carried out eLIBRARY and PubMed using the keywords: male infertility, sperm DNA fragmentation, etiology, causes, varicocele, oxidative stress, diagnostics, treatment. 111 studies were selected, which are included in this review.Results. Alcohol, tabacco smoking, narcotic substances, psychoemotional stress, adverse environmental factors and occupational intoxications, reproductive system infections and inflammation, varicocele and older paternal age can lead to SDF increasing and unfavorable reproductive outcomes, for natural pregnancy and while use an assisted reproductive technologies. The data on the role of metabolic syndrome in the genesis of SDF are equivocal. The oxidative stress is the main mechanism of sperm DNA damage. The SDF level can be estimated using direct (Comet, TUNEL) and indirect (SDS, SCSA) methods. Treatment of SDF is aimed at eliminating the detrimental factors, combating oxidative stress and recombinant follicle-stimulating hormone use.Conclusion. The level of SDF is an important indicator for assessing male reproductive potential and predicting the success of various methods of overcoming infertility. Recently, there has been an expansion of indications for the use of methods for assessing the integrity of sperm genetic material in the clinical practice of specialists in the field of reproductive medicine. 
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