The evolution history of 1, standard: from 1980 to 2010, WHO (WH0) Handbook published in the fifth edition, sperm morphology evaluation crit
The evolution history of 1, standard: from 1980 to 2010, WHO (WH0) Handbook published in the fifth edition, sperm morphology evaluation criteria mainly experienced 2 kinds of evolution, namely free method and strict method (Tygerberg). In the first edition, the classification of sperm cells is the basis for the method proposed by MacLeod, and there is no clear explanation of normal sperm morphology, therefore the use of free, began to recommend the so-called "Tygerberg strict standard of sperm morphology from version third". In the manual continuously published reference range of normal sperm morphology in the process from the first edition of more than 60%, down to the fifth edition of the above 4%. 2, detection methods: sperm morphology can be detected by manual analysis and computer-aided semen analysis system (compute assisted semenanalysers, CASA) to complete. CASA is more accurate than the manual detection of sperm morphology, which can detect abnormal sperm which can not be detected by the naked eye. But at present, CASA in a short period of time can not completely replace manual detection. Because of the high sensitivity of CASA, which may be in the process of testing the cell debris, dye particles or other similar cells and sperm head size misread, there is also other factors, such as differences in staining, smear preparation smear, smear the sperm density uneven background contrast, in addition to the computer testing personnel required the system analysis of sperm morphology were corrected, the accuracy will influence the results of subjectivity. WHO in the seminal analysis manual, published in 1999, points out that manual analysis includes steps such as smear, dryness, fixation, staining, and sperm counting. The manual analysis is simple and easy to operate, but because the detection methods of each laboratory is not consistent, the operation is not standardized, staining methods are not unified and so on, led to the detection results are quite different, mainly in the dyeing and sperm count. Therefore CASA and manual method has its advantages and limitations, we need each other, to make more accurate analysis report, better clinical services. The author advocates the combination of manual and computer-aided systems. 3. The standard and reference value of sperm morphology: the shape of abnormal sperm was divided into three categories: head deformity, body deformity and tail deformity. In the first edition of 1980, the average value of normal sperm morphology was 80.5%, the range was from 48% to 98%. In the second edition of 1987, the normal sperm morphology was reduced to 50%. In 1992 third edition of the manual, normal sperm morphology value becomes equal to or greater than 30%. In the fourth edition of 1999, there were no specific values for normal sperm morphology, but the rate of fertilization in vitro was reduced when the number of normal sperm was less than 15%. In 2010 the latest fifth version of the manual, this value is very low, only more than 4%. The normal sperm morphology significantly reduce the critical value for 3 main reasons: (1) the implementation of stringent evaluation criteria lead to evaluation of normal sperm morphology is too strict; (2) in abnormal sperm morphology evaluated many of the standard in the system; (3) environmental factors lead to the negative impact of a true decline. 4, clinical significance: the morphology and function of testis sperm morphology indirectly reflect the development process of DNA molecular assembly and sperm, thus indicating sperm function, including sperm motility, acrosome reaction, and zona binding ability. Any abnormal sperm morphology showed testicular damage, increased sperm deformity rate, usually indirectly reflects the spermatogenic function of the obstacles, from spermatogenesis to sperm maturation, especially the apoptosis of spermatogenic cells most likely to produce sperm deformity. Morphological abnormalities and diseases of abnormal sperm increased significantly in urinary and reproductive tract infections (such as Mycoplasma and Gardiner vaginal bacteria etc.), varicocele, use of hormone or certain chemicals (such as furan, anticancer drugs, and blood is equal), epididymal tuberculosis, mumps orchitis, concurrent allergic reaction, mental stress reaction and radiation, long-term, long-term smoking and drinking bath and environmental pollution etc.. Some experts observed in Ureaplasma urealyticum infection group of sperm head and tail adsorption of Ureaplasma urealyticum by transmission electron microscopy, and with the extension of the infection time, sperm head and tail appeared different degrees of abnormal structure. In addition to genetic factors can cause sperm defects such as globozoospermia, short tail, small head sperm and sperm head.
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