特发性少、弱精子症患者精液质量指标及辅助生殖妊娠结局相关性研究  

Correlative analysis of semen quality of idiopathic oligospermia and asthenospermia patients and the outcome of ART treatment

作　　者：孙宝刚[1] 管福来[2] 曹井贺[1] 梁鲁南[1] 董业浩[1] 房姣[1] 杨爱军[1] Sun Baogang;Guan Fulai;Cao Jinghe;Liang Lunan;Dong Yehao;Fang Jiao;Yang Aijun(Affiliated Hospital of Jining Medical College, Jining 272000, Shangdong, China;Weifang Medical University)

机构地区：[1]济宁医学院附属医院,山东济宁272000 [2]潍坊医学院

出　　处：《中国男科学杂志》2018年第2期36-40,共5页Chinese Journal of Andrology

基　　金：山东省医药卫生科技发展项目(2015WS0410);济宁市科技发展项目[济科字(2015)57号-15]

摘　　要：目的通过分析特发性少、弱精子症患者精液质量及其精子功能、体外受精/胞浆内单精子注射-胚胎移植(IVF/ICSI-ET)妊娠结局以及后代情况,探讨其对精液质量、精子功能、辅助生殖妊娠结局以及出生后代的影响。方法 132例特发性少、弱精子症患者作为实验组,50例正常生育男性纳入对照组。对比两组精子质量、精子功能指标以及妊娠结局和出生后代指标差别有无统计学意义。结果实验组与对照组一般资料的比较,男、女方患者的平均年龄、不育年限、窦卵泡数、女方激素水平比较,差异均无统计学意义(P>0.05)。实验组患者精液质量、顶体酶活性、精子-透明质酸结合率小于对照组,DNA碎片、核蛋白组型大于对照组,差异具有统计学意义(P<0.05)。与对照组相比,实验组IVF治疗者的受精率、着床率,优质胚胎率和临床妊娠率降低,流产率升高,差异有统计学意义(P<0.05)。ICSI治疗者,两组患者的受精率、着床率、优质胚胎率、临床妊娠率和流产率无明显差异。实验组对子代影响指标(诸如早产率、出生体质量、双胎妊娠率、男婴比例、出生缺陷率等)与对照组相比,差异亦无统计学意义(P>0.05)。结论在IVF/ICSI助孕的患者中,特发性少、弱精子症患者可伴有精子受精能力降低。对于IVF治疗结局不良的特发性少、弱精子症患者,ICSI受精可能会改善其助孕治疗结局。Objective To evaluate the relationship asthenospermia patinets and IVF/ICSI-ET outcome. Methods between semen quality of idiopathic oligospermia and A retrospective analysis was carried out in 132 idiopathic male infertility couples requesting IVF or ICSI treatments. Fifty men with normal fertility were set as the controls. The sperm function and outcomes of IVF/ICSI-ET treatment were compared between the experiment group and the control group. Rosults There was no differences in s mean age, years of infertility, antral follicle counts, and spouse＇s sex hormone levels between the experiment group and the control group. There were significant differences in the sperm functional parameters including semen paramete, sperm acrosin activity, sperm DNA fragmentation index（DFI）, the binding rate of motile sperm with HA receptors and rate of abnormal sperm nucleoprotein between the experiment group and the control group. There were significant differences between the idiopathic male infertility group and the patients undergoing IVF-ET treatment, in fertilization rate cleavage rate, quality of transferred embryos, clinical pregnancy rate, implantation rate and abortion rate. but there were no significant differences between the idiopathic male infertility group and the patients undergoing ICSI- ET treatment in embryo development and the outcome of pregnancy. And there was no significant difference in influence indicators in offspring including the rate of premature delivery, birth weight, the rate of bigeminal pregnancy, the proportion of male infants and the rate of birth defect between two groups. Conclusion All the datas in the study suggest that the idiopathic male infertility may have adverse effect on sperm function and the outcome of IVF treatment, but ICSI may improve its embryo development and the outcome of pregnancy.

关 键 词：少精子症 弱精子症 精子注射 细胞质内 妊娠结局 

分 类 号：R698.2[医药卫生—泌尿科学]