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卵胞质内精子注射(intracytoplasmic sperm injection,ICSI)是目前治疗男性不育最有效的方法,但在ICSI周期中仍然有1%~3%的受精失败发生。近年来逐渐发展起来的卵母细胞辅助激活(assisted oocyte activation,AOA)技术在改善ICSI后受精失败患者的妊娠结局方面取得了较为明显的效果,有望成为治疗男性不育的重要辅助手段。本文综述了卵母细胞激活机制领域的研究成果,揭示了精子中的PLCξ蛋白引起卵母细胞内Ca2+震荡进而触发激活的机制,介绍了目前对ICSI受精失败患者精子激活能力的检测与诊断方法,以及不同卵母细胞辅助激活技术如电激活,Ca2+载体和Sr Cl2等激活技术的研究现状,并总结了这些技术在安全性方面所获得的证据,在此基础上对AOA技术今后的发展方向和前景作了探讨。
Intracytoplasmic sperm injection (ICSI) is currently the most effective treatment of male infertility, but in the ICSI cycle still 1% to 3% of fertilization fails. The development of assisted oocyte activation (AOA), which has been developed in recent years, has achieved remarkable results in improving the pregnancy outcome of patients with failed fertilization after ICSI and is expected to be an important adjuvant for the treatment of male infertility. This review summarizes the research results in the field of oocyte activation mechanism and reveals the mechanism by which PLCξ protein in sperm causes the activation of Ca2 + in oocytes. The mechanism of detection and diagnosis of sperm activation in patients with failed ICSI fertilization is introduced. As well as the status quo of activation technologies of different oocyte auxiliary activation technologies such as electrical activation, Ca2 + carrier and Sr Cl2, and summarizes the evidence obtained from these technologies in terms of safety. On the basis of this, the future development of AOA technology and Prospects were discussed.