摘要：The selection of the most motile and functionally competent sperm is an essential basis for in vitro fertilization(IVF)and normal embryonic *** adopted clinical approaches for sperm sample processing intensely rely on centrifugation and wash steps that may induce mechanical damage and oxidative stress to *** a few microfluidic sperm sorting devices may avoid these adverse effects by exploiting intrinsic guidance mechanisms of sperm swimming,none of these approaches have been fully validated by clinical-grade assessment *** this study,a microfluidic sperm sorting device that enables the selection of highly motile and functional sperm via their intrinsic thermotaxis is *** by the temperature microenvironment in the fallopian tube during natural sperm selection,a microfluidic device with controllable temperature gradients along the sperm separation channel was designed and *** study investigated the optimal temperature conditions for human sperm selection and fully characterized thermotaxis-selected sperm with 45 human sperm *** indicated that a temperature range of 35–36.5℃along the separation channel significantly improves human sperm motility rate((85.25±6.28)%vs.(60.72±1.37)%;P=0.0484),increases normal sperm morphology rate((16.42±1.43)%vs.(12.55±0.88)%;P<0.0001),and reduces DNA fragmentation((7.44±0.79)%vs.(10.36±0.72)%;P=0.0485)compared to the nonthermotaxis *** thermotaxis is species-specific,and selected mouse sperm displayed the highest motility in response to a temperature range of 36–37.5℃ along the separation ***,IVF experiments indicated that the selected sperm permitted an increased fertilization rate and improved embryonic development from zygote to *** microfluidic thermotaxic selection approach will be translated into clinical practice to improve the IVF success rate for patients with oligozoospermia and asthenozoospermia.

摘要：For years, the management and treatment of male factor infertility has been ‘experience＇ and not ‘evidence＇ based. Although not evidence-based, current clinical practice involves extensive use of assisted reproductive techniques （ART）. Where specific treatments are not indicated or have failed, ART have become popular adjunctive treatments for alleviating male factor infertility. According to the limited evidence available, intrauterine insemination （IUI） may be considered as a first-line treatment in a couple in which the female partner has a normal fertility status and at least 1 × 10^6 progressively motile spermatozoa are recovered after sperm preparation. If no pregnancy is achieved after 3-6 cycles of IUI, optimized in vitro fertilization （IVF） can be proposed. When less than 0.5× 106 progressively motile spermatozoa are obtained after seminal fluid processing or sperm are recovered surgically from the testis or epididymis, intracytoplasmic sperm injection （ICSI） should be performed. Although the outcome of no other ART has ever been scrutinized as much before, no large-scale ‘macroproblems＇ have as yet been observed after ICSI. Yet, ICSI candidates should be rigorously screened before embarking on IVF or ICSI, and thoroughly informed of the limitations of our knowledge on the hereditary aspects of male infertility and the safety aspects of ART.