Tinh d\u1ecbch \u0111\u1ed3 l\u00e0 x\u00e9t nghi\u1ec7m \u0111\u1ea7u tay d\u00f9ng \u0111\u1ec3 kh\u1ea3o s\u00e1t kh\u1ea3 n\u0103ng sinh s\u1ea3n c\u1ee7a nam gi\u1edbi th\u00f4ng qua c\u00e1c th\u00f4ng s\u1ed1: \u0111\u1ed9 di \u0111\u1ed9ng, m\u1eadt \u0111\u1ed9, t\u1ef7 l\u1ec7 s\u1ed1ng, h\u00ecnh d\u1ea1ng tinh tr\u00f9ng. Tuy nhi\u00ean, m\u1ed9t s\u1ed1 \u00fd ki\u1ebfn cho r\u1eb1ng c\u00e1c th\u00f4ng s\u1ed1 n\u00e0y kh\u00f4ng ph\u1ea3n \u1ea3nh \u0111\u01b0\u1ee3c ch\u1ee9c n\u0103ng tinh tr\u00f9ng. V\u00ec v\u1eady nh\u1eefng y\u1ebfu t\u1ed1 kh\u00e1c \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn kh\u1ea3 n\u0103ng sinh s\u1ea3n c\u1ee7a nam gi\u1edbi, nh\u01b0 s\u1ef1 nguy\u00ean v\u1eb9n th\u00f4ng tin di truy\u1ec1n – DNA ph\u00e2n m\u1ea3nh \u0111ang l\u00e0 v\u1ea5n \u0111\u1ec1 \u0111\u01b0\u1ee3c quan t\u00e2m. B\u00e0i t\u1ed5ng quan c\u1ee7a Kim v\u00e0 c\u1ed9ng s\u1ef1 nh\u1eb1m gi\u1edbi thi\u1ec7u v\u1ec1 m\u1ed9t s\u1ed1 ph\u01b0\u01a1ng ph\u00e1p ph\u1ed5 bi\u1ebfn d\u00f9ng \u0111\u1ec3 x\u00e9t nghi\u1ec7m ph\u00e2n m\u1ea3nh DNA tinh tr\u00f9ng v\u00e0 s\u1ef1 \u1ea3nh h\u01b0\u1edfng c\u1ee7a ph\u00e2n m\u1ea3nh DNA v\u1edbi k\u1ebft qu\u1ea3 h\u1ed7 tr\u1ee3 sinh s\u1ea3n.<\/p>\n
C\u00f3 b\u1ed1n ph\u01b0\u01a1ng ph\u00e1p ph\u1ed5 bi\u1ebfn \u0111\u1ec3 x\u00e9t nghi\u1ec7m ph\u00e2n m\u1ea3nh DNA tinh tr\u00f9ng (DFI): (1) SCSA – sperm chromatin structure assay, (2) TUNEL, (3) COMET \u2013 Single gel electrophoresis, (4) SCD \u2013 Sperm chromatin structure. M\u1ed7i ph\u01b0\u01a1ng ph\u00e1p \u0111\u1ec1u c\u00f3 \u0111\u1eb7c \u0111i\u1ec3m, \u01b0u v\u00e0 nh\u01b0\u1ee3c \u0111i\u1ec3m ri\u00eang. (1) Ph\u01b0\u01a1ng ph\u00e1p SCSA d\u1ef1a tr\u00ean t\u00ednh \u0111\u1eb7c hi\u1ec7u c\u1ee7a thu\u1ed1c nhu\u1ed9m Acridine Orange (AO) v\u1edbi nucleotide, DNA nguy\u00ean v\u1eb9n s\u1ebd ph\u00e1t \u00e1nh s\u00e1ng hu\u1ef3nh quang m\u00e0u l\u1ee5c, DNA ph\u00e2n m\u1ea3nh ph\u00e1t hu\u1ef3nh quang m\u00e0u \u0111\u1ecf. Ph\u01b0\u01a1ng ph\u00e1p n\u00e0y \u0111\u01b0\u1ee3c \u0111\u00e1nh gi\u00e1 nhanh ch\u00f3ng, kh\u00e1ch quan v\u00e0 \u0111\u00e3 c\u00f3 ng\u01b0\u1ee1ng gi\u00e1 tr\u1ecb thi\u1ebft l\u1eadp, tuy nhi\u00ean gi\u00e1 th\u00e0nh cao v\u00e0 y\u00eau c\u1ea7u k\u1ef9 thu\u1eadt cao c\u1ee7a ng\u01b0\u1eddi th\u1ef1c hi\u1ec7n. (2) Ph\u01b0\u01a1ng ph\u00e1p TUNEL ph\u00e1t hi\u1ec7n \u0111o\u1ea1n DNA \u0111\u1ee9t g\u00e3y b\u1eb1ng c\u00e1ch g\u1eafn thu\u1ed1c nhu\u1ed9m hu\u1ef3nh quang v\u00e0o nh\u00f3m 3\u2019-OH. Ph\u01b0\u01a1ng ph\u00e1p n\u00e0y c\u00f3 \u0111\u1ed9 nh\u1ea1y cao v\u1edbi c\u00e1c tr\u01b0\u1eddng h\u1ee3p \u0111\u1ee9t g\u00e3y m\u1ea1ch \u0111\u00f4i v\u00e0 m\u1ea1ch \u0111\u01a1n, ti\u1ebft ki\u1ec7m chi ph\u00ed nh\u01b0ng t\u1ed1n nhi\u1ec1u th\u1eddi gian v\u00e0 ng\u01b0\u1ee1ng gi\u00e1 tr\u1ecb ch\u01b0a \u0111\u01b0\u1ee3c thi\u1ebft l\u1eadp. (3) Ph\u01b0\u01a1ng ph\u00e1p COMET s\u1eed d\u1ee5ng \u0111i\u1ec7n di, nh\u1eefng \u0111o\u1ea1n DNA ph\u00e2n m\u1ea3nh s\u1ebd di chuy\u1ec3n v\u1ec1 ph\u00eda c\u1ef1c d\u01b0\u01a1ng t\u1ea1o th\u00e0nh h\u00ecnh gi\u1ed1ng \u201csao ch\u1ed5i\u201d k\u1ebft h\u1ee3p v\u1edbi thu\u1ed1c nhu\u1ed9m hu\u1ef3nh quang. \u0110\u00e2y l\u00e0 ph\u01b0\u01a1ng ph\u00e1p \u00edt t\u1ed1n k\u00e9m v\u00e0 c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng trong c\u00e1c tr\u01b0\u1eddng h\u1ee3p m\u1eadt \u0111\u1ed9 tinh tr\u00f9ng th\u1ea5p, tuy nhi\u00ean th\u1eddi gian th\u1ef1c hi\u1ec7n l\u00e2u v\u00e0 quy tr\u00ecnh ch\u01b0a \u0111\u01b0\u1ee3c th\u1ed1ng nh\u1ea5t. (4) Ph\u01b0\u01a1ng ph\u00e1p SCD d\u1ef1a v\u00e0o s\u1ef1 ph\u00e2n t\u00e1n nhi\u1ec5m s\u1eafc th\u1ec3 \u0111\u1ec3 \u0111\u00e1nh gi\u00e1 t\u00ednh to\u00e0n v\u1eb9n di truy\u1ec1n c\u1ee7a tinh tr\u00f9ng. SCD nhanh ch\u00f3ng, \u0111\u01a1n gi\u1ea3n, nh\u01b0ng vi\u1ec7c \u0111\u00e1nh gi\u00e1 c\u00f2n mang t\u00ednh ch\u1ee7 quan v\u00e0 m\u1ed1i t\u01b0\u01a1ng quan v\u1edbi h\u1ed7 tr\u1ee3 sinh s\u1ea3n c\u00f2n g\u00e2y tranh c\u00e3i.<\/p>\n
Ph\u00e2n m\u1ea3nh DNA tinh tr\u00f9ng c\u00f3 \u00fd ngh\u0129a nh\u1ea5t \u0111\u1ecbnh v\u1edbi k\u1ebft qu\u1ea3 h\u1ed7 tr\u1ee3 sinh s\u1ea3n. V\u1edbi nam gi\u1edbi c\u00f3 t\u1ef7 l\u1ec7 ph\u00e2n m\u1ea3nh DNA tinh tr\u00f9ng d\u01b0\u1edbi 30% c\u00f3 kh\u1ea3 n\u0103ng c\u00f3 thai t\u1ef1 nhi\u00ean ho\u1eb7c b\u1eb1ng ph\u01b0\u01a1ng ph\u00e1p IUI. Nam gi\u1edbi v\u1edbi DFI tr\u00ean 30%, n\u00ean ch\u1ec9 \u0111\u1ecbnh IVF\/ICSI. Tuy nhi\u00ean, m\u1ed1i t\u01b0\u01a1ng quan gi\u1eefa DFI v\u1edbi k\u1ebft qu\u1ea3 thai v\u1eabn c\u00f2n nhi\u1ec1u tranh c\u00e3i. M\u1ed9t s\u1ed1 \u00fd ki\u1ebfn \u0111\u01b0a ra, DFI kh\u00f4ng d\u1ef1 \u0111o\u00e1n \u0111\u01b0\u1ee3c k\u1ebft qu\u1ea3 thai ho\u1eb7c c\u00f3 m\u1ed1i t\u01b0\u01a1ng quan y\u1ebfu v\u1edbi ph\u01b0\u01a1ng ph\u00e1p ICSI\/IVF. DFI cao l\u00e0m t\u0103ng nguy c\u01a1 s\u1ea9y thai. \u0110\u1ed3ng th\u1eddi, DFI cao c\u0169ng \u0111\u01b0\u1ee3c nh\u1eadn th\u1ea5y trong nh\u1eefng tr\u01b0\u1eddng h\u1ee3p v\u1ee3 ch\u1ed3ng c\u00f3 ti\u1ec1n s\u1eed s\u1ea9y thai nhi\u1ec1u l\u1ea7n.<\/p>\n
Ch\u00ednh v\u00ec nh\u1eefng \u1ea3nh h\u01b0\u1edfng c\u1ee7a ph\u00e2n m\u1ea3nh DNA tinh tr\u00f9ng l\u00ean k\u1ebft qu\u1ea3 sinh s\u1ea3n n\u00ean c\u1ea3i thi\u1ec7n ch\u1ec9 s\u1ed1 DFI l\u00e0 \u0111i\u1ec1u c\u1ea7n thi\u1ebft. \u0110\u1ea7u ti\u00ean, nam gi\u1edbi n\u00ean c\u00f3 l\u1ed1i s\u1ed1ng l\u00e0nh m\u1ea1nh: t\u1eeb b\u1ecf thu\u1ed1c l\u00e1, h\u1ea1n ch\u1ebf ti\u1ebfp x\u00fac h\u00f3a ch\u1ea5t \u0111\u1ed9c h\u1ea1i…; \u0111i\u1ec1u tr\u1ecb v\u1edbi thu\u1ed1c ch\u1ed1ng oxy h\u00f3a; \u0111i\u1ec1u tr\u1ecb gi\u00e3n t\u0129nh m\u1ea1ch th\u1eebng tinh; s\u1eed d\u1ee5ng m\u1ed9t s\u1ed1 ph\u01b0\u01a1ng ph\u00e1p l\u1ef1a ch\u1ecdn tinh tr\u00f9ng tr\u01b0\u1edbc khi ICSI; s\u1eed d\u1ee5ng tinh tr\u00f9ng t\u1eeb m\u00e0o tinh. Hi\u1ec7n nay vi\u1ec7c l\u1ef1a ch\u1ecdn ph\u01b0\u01a1ng ph\u00e1p n\u00e0o \u0111\u1ec3 c\u00f3 k\u1ebft qu\u1ea3 ch\u00ednh x\u00e1c trong ART c\u00f2n nhi\u1ec1u kh\u00f3 kh\u0103n. V\u00ec v\u1eady c\u1ea7n c\u00f3 nhi\u1ec1u nghi\u00ean c\u1ee9u h\u01a1n n\u1eefa \u0111\u1ec3 x\u00e1c \u0111\u1ecbnh \u0111i\u1ec3m cut-off DFI trong ART, c\u00f9ng v\u1edbi nh\u1eefng ph\u01b0\u01a1ng ph\u00e1p \u0111\u1ec3 l\u1ef1a ch\u1ecdn \u0111\u01b0\u1ee3c tinh tr\u00f9ng v\u1edbi DNA nguy\u00ean v\u1eb9n.<\/p>\n