- Spermiologie
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La vitalité des spermatozoïdes
The viability of spermatozoa
Andrologie volume 11, pages 45–55 (2001)
Résumé
Malgré l’existence de nombreux moyens d’étude de la vitalité des spermatozoïdes, la plupart restent dans le domaine de la recherche biomédicale. Ce sont surtout les tests classiques, tels que le test à l’éosinenigrosine et le test de gonflement flagellaire en milieu hypo-osmolaire (HOST) qui permettent d’apprécier le pourcentage de vitalité des spermatozoïdes en spermiologie courante. Un résultat anormalement bas définit la nécrozoospermie, dont l’interprétation est souvent difficile, mais permet d’orienter le bilan masculin vers la recherche de certains contextes étiologiques, notamment celui des infections génitales chroniques.
L’étude de la vitalité des spermatozoïdes constitue également l’élément-clé dans le choix des spermatozoïdes susceptibles d’être utilisés en vue d’une micro-injection intracytoplasmique. Dans cette indication, seuls les tests en milieu hypo-osmolaire sont applicables. Une analyse individuelle de chaque spermatozoïde avec un temps de séjour minimal dans la solution hypo-osmolaire semble actuellement préférable.
L’exploration de la vitalité des spermatozoïdes concerne désormais également l’apoptose. Cette forme de mort cellulaire peut être mise en évidence dans les spermatozoïdes par différents moyens techniques et pose le problème de la sélection de spermatozoïdes utilisables en assistance médicale à la procréation selon des critères d’intégrité non seulement membranaire, mais aussi génomique.
Abstract
Most of the numerous techniques used to assess sperm viability only have research applications, while only two classical tests, i.e. eosin-Y and hypo-osmotic swelling test (HOST), are currently used in routine sperm analysis to determine the percentage of viable sperm.
A viability rate below 50% of living sperm defines necrozoospermia, a condition whose clinical significance is fairly difficult to assess as the mechanisms of sperm cell death are still poorly understood. However, even when a precise cause for necrozoospermia cannot be identified, abnormal viability requires further andrological investigations with particular emphasis on clinical and laboratory signs of chronic infection of the male reproductive tract.
Intracytoplasmic sperm injection (ICSI) can yield very good pregnancy rates, even in couples with the most severe forms of male infertility. However, when no motile sperm are available after sperm preparation, the outcome of ICSI is seriously impaired, probably because of a high risk of injecting dead sperm.
In these patients, sperm viability could therefore be assessed by the hypo-osmotic swelling test in order to select only viable sperm for ICSI. However, the long incubation time of sperm in the hypo-osmotic solution, as recommended in the classical HOST procedure, has been shown to be detrimental to the spermatozoa. A single sperm test able to assess the viability of each individual spermatozoon within microdroplets covered by mineral oil therefore seems to be preferable. This selection procedure is less suitable in the case of immotile frozen-thawed sperm, as viability does not appear to be reliably predicted by HOST in cryopreserved sperm.
Examination of sperm viability now also evaluates programmed cell death or apoptosis, as apoptotic alterations can be detected in spermatozoa by several techniques. The percentage of apoptotic sperm is correlated with deficient sperm parameters and poor outcome of assisted reproductive techniques. More effective selection procedures are therefore needed in order to identify spermatozoa not only with intact membranes but also with an intact genome to be used for ICSI.
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Communication aux 3èmes Journées Nationales Assurance de Qualité en Biologie de Reproduction, 26 & 27 October 2000, Nancy.
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Forges, T., Monnier-Barbarino, P. & Foliguet, B. La vitalité des spermatozoïdes. Androl. 11, 45–55 (2001). https://doi.org/10.1007/BF03034509
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DOI: https://doi.org/10.1007/BF03034509