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用于评估“理想”形态的精子比例的严格方法第5版《世界卫生组织人类精液分析实验室技术手册》(简称手册)推荐。这基于“理想”精子形态与生育力之间相关的统计学研究,以及目前一致认为精子形态的评估应该是研究生育力的主要手段。即使在可育男性的精子中“理想”形态精子所占比例也很低,但是“理想”精子形态的概念一直存在,这是一个备受争议的话题。在很长一段时间里认为,对各种异常精子进行详细分类是可选择的,甚至是多余的。该观点也反映在较早版本的世界卫生组织(WHO)手册中。然而,一些最近的研究表明,仔细评估异常精子形态对不孕症诊断、生育能力预测以及基础或公共健康研究有重要意义。一种将视频显微扫描技术和计算机视觉结合起来,并且是唯一能够评估精子生物统计学连续性的方法,已成功应用于最近的几个临床、基础和毒理学研究中。详细的精子形态的视觉评估(包括对异常精子分类得出的畸形精子指数)和更加现代的以计算机为基础的方法实际上是相辅相成的,虽然往往认为是多余的。要依据研究的领域(临床、基础、毒理学)和需要解决的问题选取最适当的方法。简要地讨论每种方法的优势以及某些限制。
A rigorous method for assessing the proportion of sperm in the “ideal” form is recommended in the WHO version 5 Human Semen Analysis Laboratory Technical Manual (abbreviated manual). This is based on a statistical study of the correlation between sperm morphology and fertility and the current consensus that the assessment of sperm morphology should be the primary means of researching fertility. Even though the proportion of “ideal” form sperm in fertile men is low, the notion of “ideal” sperm morphology persists, which is a highly debated topic. For a long time, it was considered optional to classify various abnormal sperm in detail, even redundant. This view is also reflected in earlier versions of the World Health Organization (WHO) handbook. However, some recent studies have shown that careful assessment of abnormal sperm morphology is important for the diagnosis of infertility, fertility prediction, and basic or public health research. A combination of video microscopy and computer vision, and the only method that can assess sperm biostatistics, has been successfully used in several recent clinical, basic and toxicological studies. Visual assessment of detailed sperm morphology (including the abnormal sperm index derived from abnormal sperm sorting) and the more modern computer-based approach actually complement each other, although often considered superfluous. According to the field of study (clinical, basic, toxicology) and the problems to be solved to select the most appropriate method. Briefly discuss the advantages and some limitations of each method.