原发不育精子形态对常规体外受精(IVF)结局的影响  

The effects of primary infertility and sperm morphology on in vitro fertilization outcome

作　　者：高洋[1] 刘东云[1] 张孝东[1] 黄国宁[1] 

机构地区：[1]重庆市妇幼保健院遗传与生殖研究所,重庆400013

出　　处：《重庆医科大学学报》2010年第9期1427-1429,共3页Journal of Chongqing Medical University

摘　　要：目的:探讨原发不育和精子形态分析对常规体外受精(In vitro fertilization,IVF)中受精率、妊娠率及流产率的预测价值。方法:对634例接受IVF的男方精液进行分析,观察精子形态与IVF受精率间的相关性;建立精子正常形态预测受精率的截点值(cut-off值),以正常形态cut-off值分组,比较其IVF受精率、妊娠率和流产率的差异;比较原发不育和继发不育组精子参数及IVF妊娠结局的差异。结果:①精子形态与IVF受精率呈显著正相关性。②精子形态分析预测受精率的cut-off值为12%;正常形态≥12%和正常形态<12%组间IVF受精率差异有统计学意义,妊娠率和流产率差异无显著性意义。③原发不育和继发不育组间精子密度、前向运动率、存活率、正常形态率及IVF受精率、妊娠率、流产率差异均无统计学意义;原发不育组正常形态≥12%和正常形态<12%组间IVF受精率差异有统计学意义。结论:通过建立自己中心的正常形态cut-off值可以对IVF受精率进行预测,对原发不育患者应结合精子形态综合判断来选择合适的助孕方式。Objective：To investigate the predictive value of primary male infertility and sperm morphology on the fertilization,pregnancy and abortion rate in IVF.Methods：Sperm parameters of 634 infertile husband＇s semen were analyzed to study the correlation between the sperm morphology and the fertilization rate.The cut-off value for normal morphology was determined and the hereby established borderline was then used for the rest of the study.The fertilization,pregnancy and abortion rates for each group were calculated.Sperm parameters and IVF outcomes were compared between the primary infertility group and the secondary infertility group.Results：（1）There was a significant positive correlation between the sperm morphology and the fertilization rate in IVF.（2）Morphology cut-off point was found to be 12% normal forms.A significant lower fertilization rate was seen when normal morphology forms were 12%,but there were no statistically differences between the two groups in the pregnancy and abortion rates.（3）There were no statistically differences between the primary infertility group and the secondary infertility group in the concentration,progression motility and vitality of sperm,The rates of normal morphology sperm;the rates of IVF fertilization,pregnancy and abortion.IVF fertilization rates in the primary infertility group with ≥12% normal morphology forms were significant higher than those in the group with 12% normal forms.Conclusions：Establishing a cut-off value for normal morphology is useful to forecast the fertilization rate in IVF.In primary infertility patients,sperm morphology could be considered as an important parameter to help doctor to choose a suitable scheme of Assisted Reproductive Technology.

关 键 词：原发不育 精子形态 体外受精 辅助生殖 

分 类 号：R711.6[医药卫生—妇产科学]