
Роль тератозооспермии при мужском бесплодии и невынашивании беременности
Резюме
Тератозооспермия — повышенное содержание сперматозоидов с видимыми при светооптической микроскопии дефектами — частое нарушение качества спермы у мужчин из бездетных пар. Роль тератозооспермии в бесплодии и невынашивании беременности остается темой дискуссий в течение последних десятилетий. Обзор посвящен эволюции взглядов на роль морфологии сперматозоидов в репродуктивной функции мужчины. Представлены последние данные о взаимосвязи морфологии сперматозоидов с генетическими и эпигенетическими особенностями мужских гамет — анеуплоидиями, метилированием и фрагментацией ДНК, протаминацией, окислительным стрессом и другими функциональными нарушениями, влияющими как на вероятность зачатия, так и на прогноз успешного развития беременности. Проведена оценка перспектив дальнейших исследований.
Ключевые слова
- тератозооспермия
- бесплодие
- сперматозоиды
- ДНК
- хроматин
- сперма
Дата поступления: 18.01.2025
Дата принятия в печать: 12.03.2025
Дата публикации: 03.07.2026
- Atmoko W, Savira M, Shah R, Chung E, Agarwal A. Isolated teratozoospermia: revisiting its relevance in male infertility: a narrative review. Translational Andrology and Urology. 2024;13(2):260-273. https://doi.org/10.21037/tau-23-397
- Arora M, Mehta P, Sethi S, Anifandis G, Samara M, Singh R. Genetic etiological spectrum of sperm morphological abnormalities. Journal of Assisted Reproduction and Genetics. 2024;41(11): 2877-2929. https://doi.org/10.1007/s10815-024-03274-8
- Beurois J, Cazin C, Kherraf ZE, Martinez G, Celse T, Touré A, Arnoult C, Ray PF, Coutton C. Genetics of teratozoospermia: Back to the head. Best Practice Research. Clinical Endocrinology Metabolism. 2020;34(6):101473. https://doi.org/10.1016/j.beem.2020.101473
- Fan Y, Huang C, Chen J, Chen Y, Wang Y, Yan Z, Yu W, Wu H, Yang Y, Nie L, Huang S, Wang F, Wang H, Hua Y, Lyu Q, Kuang Y, Lei M. Mutations in CCIN cause teratozoospermia and male infertility. Science Bulletin. 2022;67(20):2112-2123. https://doi.org/10.1016/j.scib.2022.09.026
- Kruger TF, Acosta AA, Simmons KF, Swanson RJ, Matta JF, Oehninger S. Predictive value of abnormal sperm morphology in in vitro fertilization. Fertility and Sterility. 1988;49(1):112-117. https://doi.org/10.1016/s0015-0282(16)59660-5
- Лабораторное руководство ВОЗ по исследованию спермы человека и взаимодействию спермы с цервикальной слизью. 6-е издание. ВОЗ; 2021.
- Kruger TF, Coetzee K. The role of sperm morphology in assisted reproduction. Human Reproduction Update. 1999;5(2):172-178. https://doi.org/10.1093/humupd/5.2.172
- Лабораторное руководство ВОЗ по исследованию спермы человека и взаимодействию спермы с цервикальной слизью. 4-е издание. ВОЗ; 1999.
- Menkveld R, Kruger TF. Advantages of strict (Tygerberg) criteria for evaluation of sperm morphology. International Journal of Andrology. 1995;18(Suppl 2):36-42.
- Danis RB, Samplaski MK. Sperm Morphology: History, Challenges, and Impact on Natural and Assisted Fertility. Current Urology Reports. 2019;20(8):43. https://doi.org/10.1007/s11934-019-0911-7
- Олефир Ю.В., Монаков Д.М. Клиническое значение морфологии сперматозоидов в выборе метода лечения мужского бесплодия. Экспериментальная и клиническая урология. 2021;14(3):127-132. https://doi.org/10.29188/2222-8543-2021-14-3-127-132
- Pandya RK, Jijo A, Cheredath A, Uppangala S, Salian SR, Lakshmi VR, Kumar P, Kalthur G, Gupta S, Adiga SK. Differential sperm histone retention in normozoospermic ejaculates of infertile men negatively affects sperm functional competence and embryo quality. Andrology. 2024;12(4):881-890. https://doi.org/10.1111/andr.13541
- Gatimel N, Moreau J, Parinaud J, Léandri RD. Sperm morphology: assessment, pathophysiology, clinical relevance, and state of the art in 2017. Andrology. 2017;5(5):845-862. https://doi.org/10.1111/andr.12389
- Agarwal A, Sharma R, Gupta S, Finelli R, Parekh N, Panner Selvam MK, Henkel R, Durairajanayagam D, Pompeu C, Madani S, Belo A, Singh N, Covarrubias S, Darbandi S, Sadeghi R, Darbandi M, Vogiatzi P, Boitrelle F, Simopoulou M, Saleh R, Arafa M, Majzoub A, Kandil H, Zini A, Ko E, Alvarez JG, Martinez M, Ramsay J, Jindal S, Busetto GM, Sallam H, Maldonado I, Anagnostopoulou C, Alves MG, Sengupta P, Gilany K, Evenson DP, Lewis SEM, Gosalvez J, Ambar RF, Shah R. Sperm Morphology Assessment in the Era of Intracytoplasmic Sperm Injection: Reliable Results Require Focus on Standardization, Quality Control, and Training. The World Journal of Men’s Health. 2022;40(3):347-360. https://doi.org/10.5534/wjmh.210054
- Chaiya J, Vinayanuvattikhun N, Tanprasertkul C, Chaidarun T, Mebuathong T, Kaset C. Effect of staining methods on human sperm morphometrics using HT CASA II. Journal of Gynecology, Obstetrics and Human Reproduction. 2022;51(3):102322. https://doi.org/10.1016/j.jogoh.2022.102322
- Farias LB, da Cunha Barreto-Vianna AR, de Mello MD, Dos Santos AL, da Fonte Ramos C, Fontoura P. Comparison of Diff-Quick and Spermac Staining Methods for Sperm Morphology Evaluation. Journal of Reproduction Infertility. 2023;24(3):166-170. https://doi.org/10.18502/jri.v24i3.13272
- Xu YH, Lu JC, Tang SS. Effects of six kinds of sperm staining methods on human sperm size and evaluation of their staining effects. Journal of Clinical Laboratory Analysis. 2022;36(12):e24794. https://doi.org/10.1002/jcla.24794
- Maree L, du Plessis SS, Menkveld R, van der Horst G. Morphometric dimensions of the human sperm head depend on the staining method used. Human Reproduction (Oxford, England). 2010;25(6): 1369-1382. https://doi.org/10.1093/humrep/deq075
- Hamilton TRDS, Assumpção MEOD. Sperm DNA fragmentation: causes and identification. Zygote (Cambridge, England). 2020; 28(1):1-8. https://doi.org/10.1017/S0967199419000595
- Chua SC, Yovich SJ, Hinchliffe PM, Yovich JL. How Well Do Semen Analysis Parameters Correlate with Sperm DNA Fragmentation? A Retrospective Study from 2567 Semen Samples Analyzed by the Halosperm Test. Journal of Personalized Medicine. 2023;13(3):518. https://doi.org/10.3390/jpm13030518
- Atshan M, Kakavand K, Hosseini SH, Sadighi Gilani MA, Mohseni Meybodi A, Sabbaghian M. Evaluation of sperm DNA fragmentation and chromatin structure in infertile men with immotile short-tail sperm defect. Andrologia. 2020;52(1):e13445. https://doi.org/10.1111/and.13445
- Le MT, Nguyen TAT, Nguyen HTT, Nguyen TTT, Nguyen VT, Le DD, Nguyen VQH, Cao NT. Does sperm DNA fragmentation correlate with semen parameters? Reproductive Medicine and Biology. 2019;18(4):390-396. https://doi.org/10.1002/rmb2.12297
- Francavilla S, Cordeschi G, Pelliccione F, Bocchio M, Francavilla F. Isolated teratozoospermia: a cause of male sterility in the era of ICSI?. Frontiers in Bioscience. 2007;12:69-88. https://doi.org/10.2741/2049
- Nguyen HTT, Dang HNT, Nguyen TTT, Nguyen TV, Dang TC, Nguyen QHV, Le MT. Correlations between abnormalities of morphological details and DNA fragmentation in human sperm. Clinical and Experimental Reproductive Medicine. 2022;49(1):40-48. https://doi.org/10.5653/cerm.2021.04777
- Liu K, Mao X, Pan F, Chen Y, An R. Correlation analysis of sperm DNA fragmentation index with semen parameters and the effect of sperm DFI on outcomes of ART. Scientific Reports. 2023;13(1):2717. https://doi.org/10.1038/s41598-023-28765-z
- Du C, Tuo Y. Correlation of DNA fragments with routine semen parameters and lifestyle and their impact on assisted reproductive outcomes. Revista Internacional de Andrologia. 2023;21(2):100337. https://doi.org/10.1016/j.androl.2022.03.001
- Ni K, Spiess AN, Schuppe HC, Steger K. The impact of sperm protamine deficiency and sperm DNA damage on human male fertility: a systematic review and meta-analysis. Andrology. 2016;4(5): 789-799. https://doi.org/10.1111/andr.12216
- Utsuno H, Miyamoto T, Oka K, Shiozawa T. Morphological alterations in protamine-deficient spermatozoa. Human Reproduction (Oxford, England). 2014;29(11):2374-2381. https://doi.org/10.1093/humrep/deu225
- Cui D, Han G, Shang Y, Liu C, Xia L, Li L, Yi S. Antisperm antibodies in infertile men and their effect on semen parameters: a systematic review and meta-analysis. Clinica Chimica Acta: International Journal of Clinical Chemistry. 2015;444:29-36. https://doi.org/10.1016/j.cca.2015.01.033
- Bozhedomov V, Lipatova N, Bozhedomova G, Kamarina R, Shomarufov A, Kamalov A. Sperm chromatin integrity in men from infertile couples with teratozoospermia and normozoospermia. Human Reproduction. 2022;37(Supplement 1). https://doi.org/10.1093/humrep/deac107.049
- Oumaima A, Tesnim A, Zohra H, Amira S, Ines Z, Sana C, Intissar G, Lobna E, Ali J, Meriem M. Investigation on the origin of sperm morphological defects: oxidative attacks, chromatin immaturity, and DNA fragmentation. Environmental Science and Pollution Research International. 2018;25(14):13775-13786. https://doi.org/10.1007/s11356-018-1417-4
- Yifu P, Lei Y, Shaoming L, Yujin G, Xingwang Z. Sperm DNA fragmentation index with unexplained recurrent spontaneous abortion: A systematic review and meta-analysis. Journal of Gynecology Obstetrics and Human Reproduction. 2020;101740. https://doi.org/10.1016/j.jogoh.2020.101740
- McQueen DB, Zhang J, Robins JC. Sperm DNA fragmentation and recurrent pregnancy loss: a systematic review and meta-analysis. Fertility and Sterility. 2019;112(1):54-60.e3. https://doi.org/10.1016/j.fertnstert.2019.03.003
- Li J, Luo L, Diao J, Li Y, Zhang S, Chen L, Yang T, Qin J. Male sperm quality and risk of recurrent spontaneous abortion in Chinese couples: A systematic review and meta-analysis. Medicine. 2021;100(10):e24828. https://doi.org/10.1097/MD.0000000000024828
- Ammar O, Mehdi M, Muratori,M. Teratozoospermia: Its association with sperm DNA defects, apoptotic alterations, and oxidative stress. Andrology. 2020;8(5):1095-1106. https://doi.org/10.1111/andr.12778
- Agarwal A, Tvrda E, Sharma R. Relationship amongst teratozoospermia, seminal oxidative stress and male infertility. Reproductive Biology and Endocrinology: RBE. 2014;12:45. https://doi.org/10.1186/1477-7827-12-45
- Candela L, Boeri L, Capogrosso P, Cazzaniga W, Pozzi E, Belladelli F, Baudo A, Ravizzoli A, Ventimiglia E, Viganò P, Alfano M, Abbate C, Cornelius J, Mattei A, Montorsi F, Salonia A. Correlation among isolated teratozoospermia, sperm DNA fragmentation and markers of systemic inflammation in primary infertile men. PloS One. 2021;16(6):e0251608. https://doi.org/10.1371/journal.pone.0251608
- Kovac JR, Smith RP, Cajipe M, Lamb DJ, Lipshultz LI. Men with a complete absence of normal sperm morphology exhibit high rates of success without assisted reproduction. Asian Journal of Andrology. 2017;19(1):39-42. https://doi.org/10.4103/1008-682X.189211
- Lockwood GM, Deveneau NE, Shridharani AN, Strawn EY, Sandlow JI. Isolated abnormal strict morphology is not a contraindication for intrauterine insemination. Andrology. 2015;3(6):1088-1093. https://doi.org/10.1111/andr.12098
- Deveneau NE, Sinno O, Krause M, Eastwood D, Sandlow JI, Robb P, Granlund A, Strawn EY Jr. Impact of sperm morphology on the likelihood of pregnancy after intrauterine insemination. Fertility and Sterility. 2014;102(6):1584-90.e2. https://doi.org/10.1016/j.fertnstert.2014.09.016
- Younes G, Tannus S, Son WY, Dahan MH. When to do intracytoplasmic sperm injection: a prospective comparison. Archives of Gynecology and Obstetrics. 2019;300(5):1461-1471. https://doi.org/10.1007/s00404-019-05324-4
- Keegan BR, Barton S, Sanchez X, Berkeley AS, Krey LC, Grifo J. Isolated teratozoospermia does not affect in vitro fertilization outcome and is not an indication for intracytoplasmic sperm injection. Fertility and Sterility. 2007;88(6):1583-1588. https://doi.org/10.1016/j.fertnstert.2007.01.057
- Ribas-Maynou J, Yeste M, Becerra-Tomás N, Aston KI, James E, Salas-Huetos A. Clinical implications of sperm DNA damage in IVF and ICSI: updated systematic review and meta-analysis. Biological Reviews of the Cambridge Philosophical Society. 2021;96(4):1284-1300. https://doi.org/10.1111/brv.12700
- Li F, Duan X, Li M, Ma X. Sperm DNA fragmentation index affect pregnancy outcomes and offspring safety in assisted reproductive technology. Scientific Reports. 2024;14(1):356. https://doi.org/10.1038/s41598-023-45091-6
- Fu W, Cui Q, Yang Z, Bu Z, Shi H, Bi B, Yang Q, Xin H, Shi S, Hu L. High sperm DNA fragmentation increased embryo aneuploidy rate in patients undergoing preimplantation genetic testing. Reproductive biomedicine online. 2023;47(6):103366. https://doi.org/10.1016/j.rbmo.2023.103366
- Fang L, Ye YH, Li ES, Feng GF. Magnetic-activated cell sorting (MACS) versus density gradient centrifugation (DGC) for the selection of human sperm in assisted reproductive techniques. Zhonghua Yi Xue Za Zhi. 2018;98(40):3263-3267. https://doi.org/10.3760/cma.j.issn.0376-2491.2018.40.010
- Mei J, Chen LJ, Zhu XX, Yu W, Gao QQ, Sun HX, Ding LJ, Wang JX. Magnetic-activated cell sorting of nonapoptotic spermatozoa with a high DNA fragmentation index improves the live birth rate and decreases transfer cycles of IVF/ICSI. Asian Journal of Andrology. 2022;24(4):367-372. https://doi.org/10.4103/aja202161
- Khakpour S, Sadeghi E, Tavalaee M, Bahadorani M, Nasr-Esfahani MH. Zeta method: A noninvasive method based on membrane charge for selecting spermatozoa expressing high level of phospholipaseCζ. Andrologia. 2019;51(5):e13249. https://doi.org/10.1111/and.13249
- Sefidgar Tehrani M, Amirian M, Jalali M, Attaranzadeh A, Fazel A, Ebrahimzadeh-Bideskan A. Role of the Zeta Method in Intracytoplasmic Sperm Injection Outcomes in High Sperm DNA Fragmentation in Oligoasthenozoospermic Men. Galen Medical Journal. 2018;7:e1107. https://doi.org/10.22086/gmj.v0i0.1107
- Parrella A, Medrano L, Aizpurua J, Gómez-Torres MJ. Phospholipase C Zeta in Human Spermatozoa: A Systematic Review on Current Development and Clinical Application. International Journal of Molecular Sciences. 2024;25(2):1344. https://doi.org/10.3390/ijms25021344
- Kashir J, Mistry BV, BuSaleh L, Abu-Dawas R, Nomikos M, Ajlan A, Abu-Dawud R, AlYacoub N, AlHassan S, Lai FA, Assiri AM, Coskun S. Phospholipase C zeta profiles are indicative of optimal sperm parameters and fertilisation success in patients undergoing fertility treatment. Andrology.2020;8(5):1143-1159. https://doi.org/10.1111/andr.12796
- Vallet-Buisan M, Mecca R, Jones C, Coward K, Yeste M. Contribution of semen to early embryo development: fertilization and beyond. Human Reproduction Update. 2023;29(4):395-433. https://doi.org/10.1093/humupd/dmad006
- Belloc S, Benkhalifa M, Cohen-Bacrie M, Dalleac A, Chahine H, Amar E, Zini A. Which isolated sperm abnormality is most related to sperm DNA damage in men presenting for infertility evaluation. Journal of Assisted Reproduction and Genetics. 2014;31(5):527-532. https://doi.org/10.1007/s10815-014-0194-3
- Dehghanpour F, Fesahat F, Yazdinejad F, Motamedzadeh L, Talebi AR. Is there any relationship between human sperm parameters and protamine deficiency in different groups of infertile men? Revista Internacional de Andrologia. 2020;18(4):137-143. https://doi.org/10.1016/j.androl.2019.04.003
- Tan J, Taskin O, Albert A, Bedaiwy MA. Association between sperm DNA fragmentation and idiopathic recurrent pregnancy loss: a systematic review and meta-analysis. Reproductive Biomedicine Online. 2019;38(6):951-960. https://doi.org/10.1016/j.rbmo.2018.12.029
- Wyns C, Vogiatzi P, Saleh R, Shah R, Agarwal A. Sperm morphology value in assisted reproduction: dismantling an enigma and key takeaways for the busy clinician. Therapeutic Advances in Reproductive Health. 2024;18:26334941241303888. https://doi.org/10.1177/26334941241303888
- Fernández de la Puente M, Salas-Huetos A, Valle-Hita C, Babio N, Murphy MM, Canudas S, Salas-Salvadó J. Is telomere length a biomarker of sperm quality? A systematic review and meta-analysis of observational studies. Andrology. 2024;12(2):277-288. https://doi.org/10.1111/andr.13482
- Nedelcu S, Vitthala S, Maheshwari A. Lab-based semen parameters as predictors of long-term health in men-a systematic review. Human Reproduction Open. 2024(4):hoae066. https://doi.org/10.1093/hropen/hoae066
- Божедомов В.А., Корнеев И.А., Липатова Н.А., Божедомова Г.Е., Камарина Р.А., Николаева М.А., Галимова Э.Ф., Галимов Ш.Н., Епанчинцева Е.А., Павлов В.Н., Камалов А.А. Референтные показатели базового анализа эякулята фертильных мужчин: российские региональные особенности (многоцентровое поперечное ретроспективное исследование). Урология. 2023;5:48-56. https://doi.org/10.18565/urology.2023.5.48-56
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