男性生殖道溶脲脲原体感染与IVF结局的相关性研究  

Correlation between IVF outcomes and Ureaplasma urealyticum infection in male reproductive tract

作　　者：范宇平[1] 潘家坪[1] 胡烨[1] 黄文强[1] 王羽[1] 阮井玲[1] 李赟[1] 滕晓明[1] 

机构地区：[1]同济大学附属第一妇婴保健院生殖医学中心,上海200040

出　　处：《中华男科学杂志》2014年第1期59-62,共4页National Journal of Andrology

基　　金：上海市卫生局科研课题(20124458)~~

摘　　要：目的:通过回顾性分析IVF-ET治疗前男方生殖道溶脲脲原体(Uu)培养不同结果及其处理与IVFET治疗结局的关系,探讨男性生殖道Uu对IVF结局的影响及其术前进行Uu检查的临床意义。方法:进行IVF-ET的患者,男方通过病史询问、生殖系统超声检查、染色体检查排除遗传等因素,按男方精液Uu培养结果分为阳性和阴性两组。统计两组IVF治疗受精率、卵裂率、临床妊娠率、流产率,探讨Uu阳性对IVF的结局是否存在影响。结果:经选择的973例患者中Uu培养阴性组836例,阳性组137例,阳性组治疗后未转阴7例。Uu感染和无Uu感染者间IVF受精率(79.8%vs 81.6%)、异常受精率(12.4%vs 11.8%)及卵裂率(92.1%vs 92.0%)的差异均无显著性(P=0.13、0.58、0.94),Uu治疗后未转阴者和无Uu感染者间IVF受精率(89.8%vs 81.6%)、异常受精率(13.2%vs 11.8%)及卵裂率(92.5%vs 92.0%)的差异也均无显著性(P=0.10、0.75、0.10)。行胚胎移植患者共747例,Uu感染和无Uu感染者间临床妊娠率(34.7%vs 38.6%)和流产率(22.2%vs 16.5%)差异无显著性(P=0.44、0.39),Uu治疗后未转阴者和无Uu感染者间临床妊娠率(33.3%vs38.6%)和流产率(0 vs16.5%)差异也无显著性(P=0.79、0.53)。结论:男方生殖道Uu培养阳性对IVF的受精率、异常受精率、卵裂率、临床妊娠率及流产率均没有明显影响。Uu是否阳性对IVF的结局无明显影响,但由于Uu治疗后未转阴者数量较少,可能需要更大样本验证。Objective： To investigate the influence of Ureaplasma urealyticum （Uu） infection in the male reproductive tract on the outcomes of IVF and the clinical significance of preoperative Uu test by analyzing the correlation between the results of Uu culture before IVF-ET and the outcomes of IVF-ET. Methods ： Among 1 059 couples undergoing IVF-ET, we selected 973 after excluding genetic factors and divided them into a Uu negative and a Uu positive group according to the results of culture of Uu in the semen of the males. We compared the rates of IVF fertilization, oocyte cleavage, clinical pregnancy and abortion between the two groups, and analyzed the influence of Uu infection on IVF outcomes. Results ： Among the 973 selected subjects, 836 were Uu negative （group A） and 137 Uu positive （group B）, and of the latter, 130 were restored to Uu negative after treatment （ group B1 ） and the other 7 remained unchanged （group B2）. No significant differences were found between groups A and B in the rates of IVF fertilization （81.6% vs 79.8%, P = 0.13 ）, abnormal fertilization （ 11.8 % vs 12.4%, P = 0.58 ） and oocyte cleavage （92.0% vs 92.1% , P = 0.94）, nor between groups A and B2 （81.6% vs 89.8%, P =0.10; 11.8% vs 13.2%, P =0.75 ; 92.0% vs 92.5%, P =0.10）. Totally, 747 of the patients underwent embryo transfer, including 643 in group A and 104 in group B. There were no significant differences between groups A and B in the rates of clinical pregnancy （38.6% vs 34.7%, P =0.44） and abortion （ 16.5% vs 22.2%, P =0.39）, nor between groups A and B2 （38.6% vs 33.3%, P = 0.79 ; 16.5% vs 0, P = 0.53 ）. Conclusion ： Uu infection in the male reproductive tract does not significantly affect the rates of IVF fertilization, ooeyte cleavage, clinical pregnancy and abortion. However, more investigations with larger sample sizes of the cases restored from Uu positive to Uu negative are needed to lend further support to our findings.

关 键 词：溶脲脲原体 体外受精-胚胎移植 受精率 卵裂率 临床妊娠率 流产率 

分 类 号：R698.2[医药卫生—泌尿科学]