精子DNA损伤与常规体外受精—胚胎移植结局关系研究  

A STUDY ON CORRELATION BETWEEN SPERM DNA DAMAGE AND THE OUTCOMES OF IN VITRO FERTILIZATION—EMBRYO TRANSFER

作　　者：曾玖芝[1] 袁华[2] 龚衍[1] 梁梅玉 马蓉宁[1] 熊东升[1] 

机构地区：[1]四川省妇幼保健院生殖医学中心,成都610041 [2]广西医科大学第一附属医院生殖医学中心,南宁530021

出　　处：《广西医科大学学报》2015年第4期564-567,共4页Journal of Guangxi Medical University

基　　金：国家自然科学基金资助项目(No.81200453)

摘　　要：目的：探讨精子DNA损伤对常规体外受精—胚胎移植（IVF-ET）胚胎质量结局及临床结局的影响。方法：对169例行常规IVF治疗的夫妇用精子染色质扩散实验（SCD）测定精子DNA碎片率（DFI）,据DFI值将患者分为DFI〈15%、30%〉DFI≥15%和DFI≥30%3组,比较3组间受精率、正常受精率、卵裂率、可利用胚胎率、优质胚胎率、着床率、临床妊娠率和流产率并进行相关性分析。结果：精子DFI≥30%组受精率、正常受精率均显著低于DFI〈15%组和30%〉DFI≥15%组（P〈0.05）,其余指标3组间比较差异无统计学意义（P〉0.05）。精子DFI与IVF-ET受精率、正常受精率呈显著负相关关系（r=-0.284,-0.187,P〈0.05）。精子DFI预测受精异常的ROC曲线下面积为0.669（95%CI 0.534~0.803）,截断值30.70%,敏感性41.67%,特异性93.10%。结论：精子DNA损伤对IVF-ET中的受精情况有负面影响,可用于预测受精异常。Objective：To explore the effect of sperm DNA damage on the embryo quality and clinical outcomes of in vitro fertilization-embryo transfer（IVF-ET）.Methods：IVF cycles from 169 couples were tested in the study.DNA fragmentation index（DFI）examination was performed in sperm samples.Patients were divided into DFI〈15%,30%〉DFI≥15% and DFI≥30% groups based on DFI values.The outcomes of IVF were compared among three groups,and the correlation between DFI and the IVF outcomes were analyzed.Results：Fertilization rate and normal fertilization rate were significant lower in DFI≥30% group than those in the other two groups（P〈0.05）.There was no difference in cleavage rate,useful embryos rate,good quality embryos rate,implantation rate,clinical pregnancy rate and abortion rate among three groups.DFI negatively correlated with fertilization rate and normal fertilization rate（P〈0.05）.The area under the receiver operating characteristic curve（AUC）was 0.669（95% CI=0.534~0.803）for 30.70% of SDF.The threshold level of 30.70% was derived as cut-off value to discriminate abnormal infertility rate.By this threshold,specificity was 93.10% and sensitivity was 41.67%.Conclusion：The sperm DNA damage has an adverse effect on IVF fertilization,and can be used to predict IVF fertilization.

关 键 词：精子 DNA碎片指数 体外受精 结局 

分 类 号：R698.2[医药卫生—泌尿科学]