男性年龄对常规体外受精-胚胎移植结局的影响  

Influence of male age on the outcome of conventional IVF-ET

作　　者：乜照燕[1] 吴海峰[2] 张娜[1] 郭丽娜[1] 赵素英[1] 甄秀丽[1] 吕翠婷[1] 

机构地区：[1]河北医科大学第四医院生殖医学科,河北石家庄050011 [2]河北省胸科医院,河北石家庄050041

出　　处：《中华男科学杂志》2012年第3期248-252,共5页National Journal of Andrology

基　　金：河北省医学科学研究重点课题计划(资助号:20090157)~~

摘　　要：目的:研究男性年龄对体外受精-胚胎移植(IVF-ET)治疗结局的影响。方法:按男方年龄将2008至2010年接受常规IVF-ET的夫妇170对分为3组,年龄<35岁组60例、35～39岁组77例,≥40岁组33例,观察男方年龄对IVF的受精率、卵裂率、优质胚胎率、着床率、妊娠率及流产率的影响。结果:3组精液量[(3.10±1.22)ml vs(2.84±1.05)ml vs(2.80±0.79)ml]、精子浓度[(54.23±26.07)×106/ml vs(60.27±24.80)×106/ml vs(60.21±27.42)×106/ml]、活动率[(53.93±13.25)%vs(56.10±16.58)%vs(51.82±15.45)%]相比均无显著性差异(P>0.05),≥40岁组的(a+b)级精子的百分率[(40.97±11.91)%]低于<35岁组[(48.47±11.78)%]和35～39岁组[(46.84±13.51)%],结果有显著性差异(P<0.05),≥40岁组精子正常形态[(11.76±5.97)%]与<35岁组[(15.25±6.94)%]相比,结果有显著性差异(P<0.05)。男方年龄≥40岁组的受精率(81.52%)、卵裂率(82.61%)、优质胚胎率(52.33%)、植入率(18.06%)、妊娠率(33.33%)与男方年龄<35岁组(分别为83.18%、82.68%、56.99%、22.40%、40.00%)和35～39岁组(分别为78.78%、80.66%、55.01%、21.74%、38.96%)比较,差异无统计学意义(P>0.05)。男方年龄≥40岁组患者的流产率(36.36%)与男方年龄<35岁组(8.33%)相比明显升高,但无统计学差异(P>0.05)。结论:男性年龄对前向运动精子百分率和精子正常形态率有一定影响,而与受精、胚胎质量、植入率、妊娠率、流产率没有明显的相关性。Objective： To study the influence of male age on the outcome of conventional IVF-ET. Methods ： Based on male age, 170 couples undergoing conventional IVF-ET were divided into three groups： 〈35 yr （n = 60） , 35 -39 yr （n = 77） and≥ 40 yr （ n = 33 ）. We observed the rates of fertilization, cleavage, good quality embryo, implantation, clinical pregnancy and abortion in different groups. Results ： There were no significant differences among the three groups in semen volume （ [ 3.10 ± 1.22 ] ml vs [2.84±1.05] mlvs [2.80±0.79] ml）, sperm concentration （[54.23 ±26.07] xlO6/mlvs E 60. 27 ± 24. 80 ] ×10^6/mlvs[ 60.21 ±27.42] ×10^6/ml） and sperm viability （E53.93 ± 13.25] % vs [56.10±16.581% vs [51.82±15.45] %） （P〉 0.05 ）. The men of the t〉40 yr group showed a significantly lower percentage of grade a ± b sperm （ E 40.97 ± 11.91 ] % ） than those of the 〈 35 and 35 - 39 yr groups （ [ 48.47 ± 11.78 ] % and E 46.84 ± 13.51 ] % ） （ P 〈 0.05 ）, and morphologically normal sperm （ [ 11.76 ± 5.97 ] % ） than those of the 〈 35 yr group （ [ 15.25 ± 6.94 ] % （ P 〈 0.05 ）. The rates of fertilization, cleavage, goodquality embryo, implantation, clinical pregnancy were 81.52%, 82.61%, 52.33%, 18.06% and 33.33% in the t〉40 yr group, with no significant differences from those of the 〈 35 yr group （ 83.18%, 82.68%, 56.99%, 22.40% and 40.00% ） and the 35 - 39 yr group （78.78%, 80.66%, 55.01%, 21.74% and 38.96% ） （ P 〉 0.05 ）, while the abortion rate was markedly increased in the I〉40 yr group as compared with the 〈 35 yr group （ 36.36% vs 8.33 %, P 〉 0.05 ）. Conclusion ： Increasing male age is related with decreasing percentages of progressively motile sperm and morphologically normal sperm, but not obviously with the rates of fertilization, good quality embryo, implantation, pregnancy and abortion. Natl J Androl, 2012, 18 （3） ： 248 -252

关 键 词：男性年龄 体外受精 精液分析 胚胎发育 妊娠率 

分 类 号：R698.2[医药卫生—泌尿科学]