高、低生育力捐精者复苏精液功能指标的比较性研究(附40例报告)  

Post-thaw sperm functions of high-and low-fertility sperm donors:A comparative study of 40 cases

作　　者：刘宇飞[1] 朱勇[1] 卢慧[1] 曹小蓉[1] 闫峰[1] 刘勇[1] 施文博[1] 孙璨[1] 卢克敏[1] 肖倩[1] 胡洪亮[1] 李铮[1] 

机构地区：[1]上海交通大学医学院附属仁济医院泌尿科上海市人类精子库上海市男科学研究所精子发育与遗传实验室,上海200135

出　　处：《中华男科学杂志》2014年第1期30-36,共7页National Journal of Andrology

基　　金：国家重点基础研究发展计划973计划(2011CB944504);上海市科委重点课题(10JC1409900)~~

摘　　要：目的:探讨可以全面有效评估捐精者生育力的精子功能指标,运用于复苏精液标本的筛选,旨在提高辅助生殖技术成功率。方法:根据捐精者精液使用的妊娠结局,收集上海市人类精子库高、低生育力捐精者的冷冻精液标本各20例,比较两组精液标本复苏后的精子浓度、活力、正常形态率、顶体完整率、DNA完整性以及线粒体膜电位。结果:高、低生育力组精液复苏经系列评估后,正常形态率分别为(18.50±6.10)%、(14.42±6.44)%;顶体完整率分别为(86.17±4.49)%、(80.04±7.52)%;精子DNA碎片率分别为(9.21±3.22)%、(15.72±8.20)%,以上指标经统计学分析两组之间具有显著性差异(P<0.05)。但线粒体膜电位高生育力组[(56.75±18.80)%]与低生育力组[(52.23±18.86)%]之间无显著性差异(P>0.05)。精子线粒体膜电位与精子活力呈显著正相关(r=0.760,P<0.05),其他功能指标与精子浓度、活力无显著相关。结论:精子浓度、活力与正常形态率、顶体完整率以及DNA完整性可以有效评估捐精者复苏精液生育能力。Objective： To investigate sperm function indexes that can be used to effectively evaluate the sperm donors fertility so as to select healthy post-thaw semen samples and improve the success rate of assisted reproductive technology. Methods ： According to the pregnancy outcomes, we divided 40 donor semen samples into a high-fertility group （ n = 20） and a low-fertility group （ n = 20）. The measured and compared the concentration, progressive motility, morphology, acrosome intactness, DNA integrity and mitochondrial membrane potential （MMP） of the post-thaw sperm between the two groups. Results ： There were statistically significant differences between the high- and low-fertility groups in the percentages of morphologically normal sperm （ [ 18.50± 6. 10 ] % vs [ 14.42 ±6.44 ] %, P 〈 0.01 ）, acrosome intactness （ [ 86.17 ± 4.49 ] % vs [ 80.04 ± 7.52 ] %, P 〈 0.05 ） and DNA fragmentation index （[9.21 ±3.22]% vs [15.72 ±8.20]%, P〈0.05）, but not in MMP （[56.75±18.80]% vs [52.23 ± 18.86]%, P〉 0.05 ）. A significantly positive correlation was found between MMP and sperm motility （ r = 0.760, P 〈 0.05 ）, but not between other sperm functions and sperm eoncentration and motility. Conclusion： Sperm concentration, motility, morphology, aerosome intactness rate and DNA integrity contribute effectively to the evaluation of the fertilization capacity of post-thaw donor semen samples.

关 键 词：捐精 生育能力 精子功能 精子质量 

分 类 号：R698.2[医药卫生—泌尿科学]