DNA损伤精子对卵胞质内单精子注射结局的影响  

Adverse effect of sperm DNA damage on the outcome of intracytoplas mic sperm injection

作　　者：丁玉芹[1,2,3] 姜宏[1,2] 何瑞冰[1,2] 汪存利[1,2] 

机构地区：[1]安徽医科大学解放军临床学院 [2]解放军第105医院生殖医学中心,合肥230031 [3]合肥市第二人民医院妇产科,合肥230011

出　　处：《安徽医科大学学报》2011年第2期173-176,共4页Acta Universitatis Medicinalis Anhui

摘　　要：目的探讨精子DNA损伤对卵胞质内单精子注射(ICSI)结局的影响。方法采用DNA吖啶橙染色方法(AOT)对接受ICSI治疗的63例男方精液进行精子DNA完整性分析。按精子DNA碎片指数(DFI)分为DFI>27%组与DFI≤27%组,比较两组间的受精率、早期卵裂率、优质胚胎率、胚胎着床率和妊娠率。按有无早期卵裂胚进行分组,比较两组间的优质胚胎率。结果 DFI≤27%组的早期卵裂率、优质胚胎率、胚胎着床率和妊娠率均显著高于DFI>27%组(P<0.01),但受精率在两组间差异无统计学意义;DFI与早期卵裂率、优质胚胎率、胚胎着床率和妊娠率间呈显著负相关(P<0.05)。早期卵裂组的优质胚胎率(85.3%)显著高于早期无卵裂组(65.6%)(P<0.01)。结论 ICSI过程中,精子DNA损伤并不影响受精率,但对早期卵裂率、胚胎发育和临床结局有负面影响;早期卵裂是预测胚胎发育和胚胎质量的重要指标。建议行ICSI前进行精子DNA完整性评估。Objective To explore the effect of sperm DNA damage on the outcome of intracytoplasmic sperm injection（ICSI）.Methods Sperm DNA integrity in 63 couples who underwent ICSI was evaluated with acridine orange technique.According to the DNA fragmentation index（DFI）,the patients were divided into DFI≤27% and DFI27% groups,and the rate of early embryo cleavaged,good quality embryo,implantation rate and pregnancy rate were compared between two groups.On the basis of whether existing early embryo cleavaged or not,all the embryos were classified into early cleavage group and the no early cleavage group,and the good quality embryos rates between two groups were compared.Results The rate of early embryo cleavaged and good quality embryo,implantation rate and pregnancy rate were significantly lower in DFI27% group than DFI≤27% group（P0.01）,and DFI had negative correlation with early cleavage rate,good quality embryo rate,implantation rate and pregnancy rate（P0.05）.The good quality embryo rate in early cleavage group was significantly higher than no early cleavage group（P0.01）.Conclusion During the procedure of ICSI,sperm DNA integrity doesn′t influence the fertilization,but have an adverse effect on embryo development and the outcome of ICSI,and the early cleavage may have a predictive value for embryo quality.It is suggested that the sperm DNA integrity should be evaluated before ICSI.

关 键 词：精子 DNA损伤 不育 男(雄)性 精子注射 细胞质内 

分 类 号：R321.1[医药卫生—人体解剖和组织胚胎学]