精子DNA完整性对体外授精-胚胎移植妊娠结局的影响  

Influence of the sperm DNA integrity on the clinical pregnancy outcomes of in vitro fertilization and embryo transfer

作　　者：汪李虎[1] 汪艳 梁嘉颖[1] 杨少芬[1] 杨旭辉[1] 张杰[1] 朱照平[1] 易艳红[1] 

机构地区：[1]广东省妇幼保健院生殖健康与不孕症科,广州510010 [2]广州金域检验中心

出　　处：《中国男科学杂志》2016年第10期38-41,共4页Chinese Journal of Andrology

摘　　要：目的探讨精子DNA完整性对体外受精-胚胎移植(IVF-ET)临床结局的影响。方法采用染色质扩散实验(SCD)对接受203个周期IVF-ET治疗的男方精液进行精子DNA完整性检测。因女方卵巢反应差取消10个周期,剩余193个周期。根据精子DNA碎片指数(DFI)是否超过30%和是否药物治疗分为3组:DFI异常组55例(DFI>30%),DFI正常组(DFI<30%)78例和DFI治疗组60例,其中DFI治疗组指患者DFI>30%,经药物治疗3个月,降至30%以下。比较DFI与受精率、2PN受精率、卵裂率及优胚率的相关性;比较3组间的种植率、妊娠率和流产率。结果精子DFI与受精率、2PN受精率及卵裂率均无显著相关性(P>0.05),与优胚率具有显著负相关(P<0.05)。DFI正常组和DFI治疗组(治疗后DFI<30%)的种植率及妊娠率均高于DFI异常组,差异有统计学意义(P<0.05)。DFI正常组与DFI治疗组的种植率及妊娠率差异均无统计学统计(P>0.05)。3组流产率表现相当,差异均无统计学意义(P>0.05)。结论精子DNA完整性对受精率、2PN受精率及卵裂率无影响,对优胚率、种植率及妊娠率有负面影响,药物改善精子DNA完整性后可提高优胚率、种植率及妊娠率。Objective To investigate the influence of sperm DNA integrity on the clinical pregnancy outcomes of in vitro fertilization （IVF-ET）. Methods This study included 203 couples accepted conventional IVF-ET cycles. 193 couples had finally finished the study due to cancelling 10 cases. Sperm chromatin dispersion （SCD） was used to test sperm DNA integrity. According to the level of sperm fragmentation index（DFI） and weather treatment the high DFI or not, the cases were divided into the normal DFI group（DFI〈30% ） and the abnormal DFI group（DFI≥30%） group and treatment DFI group（DFI≥0% after treatment）, and the results among the three groups were compared. Rosults No statistically significant correlation were observed among sperm DFI with fertilization rates, 2PN fertilization rates and zygote transgene rates （P〉0.05）, but DFI was negatively correlated with the optimal embryo rates （P〈0.05） between the normal DFI group and the abnormal DFI group or between the abnormal DFI group and the treatment DFI group. The implantation rate and clinical pregnancy rate in the normal DFI group and the treatment DFI group were higher than the abnormal DFI group, showing significant difference （P〈0.05）. No statistically significant difference was observed between the normal DFI group and the treatment DFI group. Conclusion In IVF-ET treatment, the sperm DNA integrity has no effect on fertilization rate, 2PN fertilization rates and zygote ttansgene rates, but DFI has negative effect on optimal embryo rates, implantation rate and clinical pregnaney rate. The optimal embryo rates, implantation rate and clinical pregnancy rate might increased if DFI exceeded 30% after treatment.

关 键 词：受精 体外 精子DNA完整性 妊娠结局 

分 类 号：R321.33[医药卫生—人体解剖和组织胚胎学]