密度梯度离心方式对人工授精结局的影响  

The influence of density gradient centrifugation with different mode on the outcome of intrarauterine insemination

作　　者：朱立华[1] 肖新燕[1] 许玉刚[1] 孙秀芬[1] 

机构地区：[1]山东省聊城市第二人民医院生殖内分泌科,临清252600

出　　处：《中国男科学杂志》2016年第2期17-20,25,共5页Chinese Journal of Andrology

摘　　要：目的探讨精液经密度梯度离心时经水平转子和角转子处理后对精液质量及其对人工授精结局的影响。方法回顾性分析352个人工授精周期，根据梯度离心时转子的不同，分成水平转子组和角转子组两组，精液经密度梯度离心法处理，形态学分析严格按照WHO（World Health Organization）人类精液检验与处理实验手册第五版标准，比较处理后精液质量及两组对妊娠结局的影响。结果（1）精液质量比较：水平转子组前向运动精子为（89．2±8．5）％、精子浓度为（47．8±14．3）×10^6／mL、前向运动精子总数为（13．6±6．3）×10^6；角转子组前向运动精子为（90．1±8．8）％、精子浓度为（43．4±15．1）×10^6／mL、前向运动精子总数为（12．9±6．1）×10^6，无统计学差异（P〉0．05）。水平转子组和角转子组正常精子比率分别为（18．5±8．2）％和（14．2±5．7）％，两者存在显著性差异（P〈0．05）；（2）妊娠结局比较：水平转子组的临床妊娠率为16．5％（30／182）、流产率为3．3％（1／30）、活产率为96．7％（29／30）；角转子组生化妊娠率为临床妊娠率为12．4％（21／170）、流产率为9．5％（2／21）、活产率为90．5％（19／21），无统计学差异（P〉0．05），生化妊娠率：两组分别为0％（0／30），19．2％（5／26），有统计学意义（P〈0．05）。结论密度梯度离心应用水平转子可以降低对处理后精液的精子形态的影响，减少生化妊娠率。Objective To assess the influence of density gradient centrifugation with swing-out rotors and fixed-angle rotors on sperm quality, and the outcomes ofintrarauterine insemination（IUI）. Methods 352 IUI cycles were retrospectively analyzed in the study. Semen samples were processed with density gradient centrifugation, and were divided into swing-out rotors group and fixed-angle rotors group based on different rotors. Sperm quality and morphology were analyzed strictly according to the fifth edition of the World Health Organization laboratory manual for the examination and processing of human semen. Sperm quality and outcomes of IUI were comparatively analyzed between the two groups. Results （1） Sperm quality： There were no significant differences between two groups in the percent of progressive motility sperm, sperm density, the total number of progresive sperm （89.2±8.5）%, （47.8±14.3）× 10^6/mL, （12.9±6.1）× 10^6 in swing-out rotors group and （90.1±8.8）%, （43.4±15.1）×10^6/mL, （12.9±6.1）×10^6 in fixed-angle rotors group, P〉0.05）, but there was a significant difference in the percent of normal morphology sperm between the two groups（18.5±8.2）% and （14.2±5.7） %, P〈0.05. （2） Outcomes of IUI. There were no significant differences between the two groups in clinical pregnancy rate, abort ratio and live birth rate （16.5%（30/182）, 3.3%（1/30）, 96.7%（29/30） in swing-out rotors group and 12.4%（21/170）, 9.5%（2/21）, 90.5%（19/21） in fixed-angle rotors group;P〉0.05）. But there was a significant difference in biochemical pregnancy rate 0%（0/30） in swing-out rotors group, 19.2%（5/26） in fixed-angle rotors group; P〈0.05. Conclusion Density gradient centrifugation with swing-out rotors could reduce the influence to sperm normal morphology and decrease the biochemical pregnancy rate.

关 键 词：授精 人工 离心法 梯密度 妊娠结局 

分 类 号：R321-33[医药卫生—人体解剖和组织胚胎学]