精子顶体反应率对宫腔内人工授精临床妊娠率的影响  

Effects of sperm acrosome reaction on clinical pregnancy rate of intrauterine insemination

作　　者：杨满[1] 唐侨飞[1] 李艳琼[1] 王锦华[1] 

机构地区：[1]广东省梅州市人民医院生殖医学科,514031

出　　处：《中国优生与遗传杂志》2016年第2期108-110,共3页Chinese Journal of Birth Health & Heredity

摘　　要：目的 探讨精子顶体反应率与宫腔内人工授精临床妊娠率的关系。方法 选取2013年3月-2014年5月我院生殖医学科宫腔内人工授精周期120例,均为促排卵周期且药物与方案一致,排除女方不育因素,术前2-7d取精模拟IUI精液优化,优化后的精液经钙离子载体A23187诱发顶体反应、PSA-FITC染色后观察并计数精子顶体反应率,比较妊娠组与未妊娠组患者精子顶体反应（Acrosome Reaction,AR）率,探讨诱发AR率与IUI临床妊娠率的关系,3次IUI未孕与妊娠组患者诱发顶体反应率的比较。结果 120例周期中,临床妊娠17例,总临床妊娠率14.17%（17/120）。其中3次IUI未孕患者8例。妊娠组与未妊娠组患者处理后正常形态率、前向运动精子总数、正常形态精子前向运动精子总数、自发AR率分别比较,均无统计学差异（P〉0.05）,而妊娠组患者诱发AR率显著高于未妊娠组（P〈0.05）。诱发AR率小于15%、15%~30%、30%~50%、大于50%4组妊娠率分别为0%（0/12）、12.5%（3/24）、13.2%（5/38）、19.6%（9/46）,诱发AR率小于15%患者临床妊娠率显著降低（P〈0.05）;3次IUI未孕组与妊娠组诱发AR率分别15.35±17.62、63.75±14.33,3次IUI未孕组诱发AR率明显低于妊娠组（P〈0.05）。结论 精子顶体反应率与宫腔内人工授精临床妊娠率有相关性,当诱发顶体反应率小于15%时妊娠率明显降低;反复IUI发生与顶体反应率降低密切相关。Objective： To research the relationship between sperm acrosome reaction and clinical pregnancy rate in intrauterine insemination （IUI） .Methods： 120 cycles of IUI were collected in our hospital from March 2013 to May 2014.A11 cases were stimulated ovulation with same paths and drugs.Acrosome reaction were induced by calcium ionophore A23187, and stained by PSA-FITC before IUI operation.Acrosome reaction rates were compared between pregnancy and non-pregnancy groups, and the relationship between inducing rate of AR and IUI clinical pregnancy rate of IUI unfertilized and pregnancy group were compared. The relationship of induced acrosome reaction rate between three IUI unfertilized and pregnancy group were compared. Reslults： 17 cases got clinical pregnancy, and 8 patients undergo failed IUI cycles for three times.Induced AR rate of pregnancy group is significantly higher than non-pregnancy group （P〈0.05） .Pregnancy rate of four groups （less than 15%, 15% - 30% and 15% 30%, more than 50%） was 0% （0/12） , 12.5% （3/24） , 13.2% （5/38） , 19.6% （9/46） , and clinical pregnancy rate were significantly decreased in first group （P〈0.05） ： induce AR rate of patients clinical pregnancy rate significantly decreased （P 〈0.05） . Conclusion： The clinical pregnancy rate of IUI was related with AR rate, the pregnancy rate decreased substantially as the AR rate was lower than 15%.Repeated IUI failure was closely related with AR rate.

关 键 词：精子顶体反应率 宫腔内人工授精 妊娠率 

分 类 号：R714.8[医药卫生—妇产科学]