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目的：研究男性不育患者的精子功能；探讨精卵结合检测在体外受精、胚胎移植术（in vitro fertilization and embryo transfer, IVF-ET）助孕中的应用价值。方法收集在济宁医学院附属医院生殖医学科就诊并行IVF治疗的89例男方患者，根据不孕不育原因分为男性不育组（A组）44例和完全女方因素引起的不孕不育组（B组）45例，将A组随机分为A1组和A2组各22例分别行IVF-ET与卵胞浆内单精子注射（intracytoplasmic sperm injection, ICSI）受精，将A1组受精率小于30%的行早期补救。将两组男方的精子利用废卵分别进行精卵结合实验和透明带诱发精子顶体反应实验。观察A组与B组平均精卵结合数和透明带诱发精子顶体反应情况，比较分析两组受精率、卵裂率、优质胚胎率及临床妊娠率的差别，分析透明带诱发精子顶体反应率与受精率的关系。结果 A组平均精卵结合数（65.84±10.27）和透明带诱发精子顶体反应率[（43.87±17.65）%]明显低于B组的平均精卵结合数（89.93±8.73）及透明带诱发精子顶体反应率[（79.48±14.45）%]，差异具有统计学意义（P＜0.05）；A1组的受精率（43.37%）明显低于B组（73.21%）和A2组（66.19%），差异具有统计学意义（P ＜0.05）；而经补救ICSI后A1组受精率为63.36%，与B组和A2组相比，差异无统计学意义（P＞0.05）。A1组的优胚率（41.35%），与A2组（50.74%）及B组的优胚率（58.11%）相比，差异无统计学意义（P＞0.05）；A2组的受精率及优胚率与B组比较，差异也无统计学意义（P＞0.05）；A组的妊娠率（43.18%）与B组（48.89%）相比，差异无统计学意义（P＞0.05）；A1组的受精率与透明带诱发精子顶体反应率具有明显的相关性，有统计学意义（r=0.889，P＜0.01）。结论精卵结合及透明带诱发精子顶体反应是有重要意义的精子功能检测实验。开展精卵结合试验以及透明带诱发精子顶体反应试验能够更好的预测精子的受精能力，为临床治疗提供更有价值的信息。早期补救ICSI可以有效避免完全不受精或低受精率的情况，可以显著改善实验室及临床结局。“,”Objective To study the clinicl significance of the sperm-zona pellucida (ZP) binding and ZP-induce dacrosome reaction for patients with man infertility and discuss its applicaton value in IVF. Methods Based on the causes of infertility, 89 patients were divided into an unexplained infertility group( 44cases,GroupA) and a pure female tubal factor group( 44cases,Group B). The patients in GroupA were further randomly divided into two subgroups Group A1(patients treated with conventional in vitrofertilization, IVF) and Group A2(patients treated with intracytoplasmic sperm injection (ICSI) fertilization). Patients in Group B receivedconventional IVF. The fertilization rate of Group A1 was less than 30%, the early rescue ICSI was carried out. Sperm-ZP binding and ZP-induced acrosome reaction experiments were conducted with 2 groups of men’s sperms separately. The number of sperm-egg binding and ZP-induced acrosome reaction rate were compared and the relationship between the ZP-induced acrosome reaction and fertilization rate was analyzed. The fertilization rate, good embryo rate and pregnancy rate in patients with man infertility after fertilization in 2 ways were investigated. Results The average number of sperm-egg binding (65.84±10.27) and the ZP-induced acrosome reaction rate (43.87±17.65)% in Group A were lower than those in Group B [89.93±8.73, (79.48±14.45)% ]. The difference between the average number of sperm-egg binding and the ZP-induced acrosome reaction was significant (P0. 05). Fertilization rate and the rate of acrosome reaction had marked positive correlation with statistical significance(r=0. 889, P<0.01). Conclusion ZP binding and ZP-induced acrosome reaction are very important experiments for evaluating sperm function of male patients with infertility. They can predict sperm fertilization ability and provide valuable information for clinical treatment. Early rescue ICSI can effectively avoid complete fertilization failure or low fertilization rate, and significantly improve clinical outcome.