上游处理前后正常形态精子百分率与体外受精-胚胎移植结局的关系  

Outcomes of IVF-ET and percentage of morphologically normal sperm before and after swim-up treatment

作　　者：周莹莹[1] 潘伯臣[1] 何丽霞[1] 杨大磊[1] 李正涛[1] 王秀霞[1] 

机构地区：[1]中国医科大学附属盛京医院辅助生殖中心,辽宁沈阳110004

出　　处：《中华男科学杂志》2012年第6期527-530,共4页National Journal of Andrology

摘　　要：目的:探讨取卵当日上游处理前后精子形态与体外受精-胚胎移植(IVF-ET)治疗结局的关系。方法:选取因单纯输卵管因素不孕而拟行IVF-ET治疗的夫妇94对。使用Kruger标准评价取卵当日上游处理前后的精子形态。以正常精子形态百分率10%为界,分别将上游处理前后的精子分成两组:B1组上游处理前正常形态≥10%,B2组<10%;A1组上游处理后正常形态≥10%,A2组<10%。分别比较B1和B2组以及A1和A2组的IVF-ET治疗结局。结果:上游处理前,B1组的受精率、卵裂率、优质胚胎率、妊娠率和胚胎种植率分别为(72.90±4.23)%、(95.20±2.61)%、(23.35±5.19)%、39.58%、18.35%;B2组分别为(71.33±5.10)%、(95.71±2.88)%、(20.18±6.15)%、41.86%、21.28%;各项指标两组之间差异均无统计学意义(P>0.05)。上游处理后,A1组受精率、卵裂率、优质胚胎率、妊娠率、胚胎种植率分别为(72.72±3.35)%、(95.64±2.04)%、(24.39±4.57)%、50.00%、23.87%;A2组分别为(70.27±8.82)%、(94.82±4.94)%、(13.45±7.39)%、9.52%、6.25%;两组之间受精率及卵裂率差别无统计学意义(P>0.05),但A1组的优质胚胎率、妊娠率及种植率明显高于A2组(P<0.05)。结论:取卵当日经上游处理后的正常精子形态百分率对IVF-ET结局有较好的预测价值。Objective： To study the relationship between sperm morphology and the outcomes of in vitro fertilization-embryo transfer （IVF-ET） before and after swim-up treatment of sperm on the day of oocyte retrieval. Methods ： This study included 94 cou- ples to be treated by IVF-ET for tubal factor infertility. Sperm samples were collected on the day of oocyte retrieval and sperm morphology evaluated according to the Kruger criteria before and after swim-up treatment. Based on the results of morphological evaluation, the sperm samples were divided into groups A1 （morphologically normal sperm I〉 10% after swim-up treatment）, A2 （morphologically normal sperm 〈 10% after swim-up treatment）, B1 （morphologically normal sperm ≥ 10% before swim-up treatment） and B2 （mor- phologically normal sperm 〈 10% before swim-up treatment）. The outcomes of ｜VF-ET treatment were compared between groups A1 and A2 as well as between B1 and B2. Results： After swim-up treatment, the rates of fertilization, cleavage, good quality embryo, clinical pregnancy and embryo implantation of group A1 were （72.72 ± 3.35 ） %, （95.64 ± 2.04） %, （24.39 ± 4.57 ） %, 50.00% and 23.87%, respectively, while those of group A2 were （70.27 ± 8.82） %, （94.82 ± 4.94） %, （ 13.45 ± 7.39） %, 9.52% and 6.25% , respectively, the latter three indexes remarkably higher in A1 than in A2 （P 〈0.05）, but the differences in the former two not statistically significant （ P 〉 0.05 ）. Before swim-up treatment, the above five indexes were （ 72.90 ± 4.23 ） %, （ 95.20 ± 2.61）%, （23.35±5. 19）%, 39.58% and 18.35% in group B1, as compared with （71.33 ±5.10）%, （95.71 ±2.88）%, （20.18 ±6.15）%, 41.86% and 21.28% in group B2, with no statistically significant differences between the two groups （P 〉 0.05 ）. Conclusion ： The percentage of morphologically normal sperm after swim-up treatment on the day of oocyte retrieval may be a valuable predictor of the outcomes of IVF-ET.

关 键 词：精子形态 Kruger标准 体外受精-胚胎移植 受精率 妊娠率 

分 类 号：R714.8[医药卫生—妇产科学]