人类精子中段形态对胚胎发育的影响  

Impact of sperm midpiece morphology on embryo development following intracytoplasmic morphologically selected sperm injection

作　　者：孟祥黔[1] 龚艺[2] 黄军[1] 曾永梅[1] 全松[2] 钟影[1] 

机构地区：[1]四川省成都市锦江区妇幼保健院生殖医学中心,四川成都610016 [2]南方医科大学南方医院妇产科生殖医学中心,广东广州510515

出　　处：《南方医科大学学报》2016年第2期255-259,共5页Journal of Southern Medical University

基　　金：四川省科学厅基础医学研究项目(2012JY0066);四川省医学科研青年创新课题(Q15056);广东省科技计划项目(2013B0022000017)

摘　　要：目的在高倍镜下观察精子中段的形态,从而评估精子中心体功能,从而探讨精子中段形态与中心体功能的关系以及中段形态不同的精子对胚胎发育的影响。方法针对57例在成都市锦江区妇幼保健院生殖医学中心行ICSI（卵胞浆内单精子注射）技术治疗的患者,将首先在低倍镜（×200~×400）下挑选过的精子再次利用MSOME（精子细胞器官形态学检查）系统,在6 000倍放大镜下对精子进行精子中心体形态分组（A组：1≤a/b≤1.2;B组：a/b≥1.5;C组：其他不规则形态）,然后分别将这3组精子注射入卵后,分组进行胚胎培养,最终观察每组胚胎发育和着床情况。结果 A,B,C 3组比较发现D3移植优胚率（79.7%vs 55.6%vs33.3%）和胚胎着床率（43.2%vs 11.1%vs 0%）在3组之间均有显著性差异（P〈0.05）;而正常受精率（73.3%vs 80.4%vs 63.5%）、囊胚利用率（23.2%vs 22.2%vs 9.09%）、胚胎冷冻率（29.2%vs 25.0%vs 13.0%）、D3优胚率（35.3%vs 37.8%vs 18.8%）上均无显著性差异（P〉0.05）。结论中心体形态较好的精子注射入卵后,可获得较高正常受精的胚胎,能显著提高第3天可移植优胚的几率,同时能显著改善胚胎的着床率,但由于样本量较少,仍然需要较大的样本量来进一步证实,为精子中心体的相关研究提供参考。Objective To evaluate the impact of sperm midpiece morphology observed under high- power microscope on embryo development following intracytoplasmic morphologically selected sperm injection. Methods Morphologically normal sperms from 57 patients undergoing intracytoplasmic sperm injection（ICSI） for male- factor infertility were selected microscopically（magnification of ×200 or 400） and subjected to motile sperm organellar morphology examination（MSOME） at high magnification of ×6000. According to the morphology of sperm medpiece, the sperms were divided into 3 groups, namely group A with a/b of 1- 1.2, group B with a/b≥1.5, and group C with irregular morphology. The sperms in the 3 groups were intracytoplasmically injected in oocytes and the outcomes of the embryos were compared. Results Groups A, B, and C showed significant differences in the rate of ET-D3 top quality embryo（79.7% vs 55.6 % vs 33.3%） and implantation rate（43.2% vs 11.1%vs 0%）, but not in the fertilization rate（73.3% vs 80.4% vs 63.5%）, blastocyst formation rate（23.2% vs 22.2% vs 9.09%）,cryopreservation rate（29.2% vs 25.0 % vs 13.0%）, or D3 top quality embryo rate（35.3% vs 37.8% vs 18.8%）. Conclusion In ICSI cycle, selecting morphologically normal sperms for intracytoplasic injection can increase the normal fertilization rate and top quality embryo rate on the transfer day and improve the implantation rate of the embryo.

关 键 词：卵胞浆内单精子注射 精子细胞器官形态学检查 中心体 胚胎 

分 类 号：R714.8[医药卫生—妇产科学]