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대한생식의학회지 제21권 제2호 2010년

체외수정 실패 정자에 대한 전자현미경적 연구

전남대학교 의과대학 산부인과학교실;전남대학교 의과대학 산부인과학교실;전남대학교 의과대학 병리학교실;전남대학교 의과대학 병리학교실;

이여일;나재형;이재혁;정상우;,

Ultrastructural Study on Spermatozoa of Failed In Vitro Fertilization

Lee, Yu-Il;Na, Jae-Hyung;Lee, Jae-Hyuk;Juhng, Sang-Woo;

Department of Obstetrics and Gynecology, Chonnam University Medical;Department of Obstetrics and Gynecology, Chonnam University Medical;Department of Pathology Chonnam University Medical;Department of Pathology Chonnam University Medical;

Failure of in vitro fertilization may occur even though oocyte and semen parameters seem satisfactory. Quantified ultrastructural study of spermatozoa was performed in three cases of failed in vitro fertilization. The results were compared to those of four fertile men. Quantification was achieved by cataloguing cell defects of the spermatozoon heads and mid/principal pieces of the flagella. Using the data from each specimen, the percentages of total cellular abnormalities in the head/mid/principal pieces were established. The percentages of anomalies of the midpiece and of the principal piece were not significantly different between failed cases and controls. The percentage of cell alterations of the head (96-100 vs 75${\pm}$3,4%), the percentage of combined anomalies of the head (80-86 vs 52.5${\pm}$1.9%), and the percentages of nuclear shape deformation (68-86 vs 47.5${\pm}$6.3%), acrosomal defects (86-96 vs 50${\pm}$4.3%), and postacrosomal sheath defects (78-88 vs 44.5${\pm}$7.2%) of the head were significantly different between failed cases and controls. Due to the cost and time involved in processing semen samples for electron microscopy, the widespread application of this technique to all couples presenting for IVF certainly is not warranted. However, in selected instances electron microscopy may play a crucial role in identifying an occult male factor.

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