精子DNA碎片对IVF/ICSI结局的影响  

Study on sperm DNA fragmentation effecting on the outcomes of in vitro fertilization/intracytoplasmic sperm injection

作　　者：柳祖波 余柯达[1] 邹立波[1] 师帅[1] 刘鸿[1] 陈晓[1] LIU Zu-bo;YU Ke-da;ZOU Li-bo;SHI Shuai;LIU Hong;CHEN Xiao(Center of Reproductive Medicine,Jinhua People＇s Hospital,Zhejiang Jinhua,321000,China)

机构地区：[1]金华市人民医院生殖医学中心,浙江金华321000

出　　处：《中国优生与遗传杂志》2018年第9期105-107,共3页Chinese Journal of Birth Health & Heredity

基　　金：浙江省自然科学基金青年项目No.LQ15H250001andLQ16H160014;浙江省生殖医学重点科技创新团队自选项目2011R50013;金华市科学技术研究计划项目2014-3-063支持

摘　　要：目的探讨精子DNA碎片对体外受精/卵胞浆内单精子注射(IVF/ICSI)结局的影响。方法回顾性的分析了行IVF/ICSI治疗的725例不孕夫妇(IVF 502例、ICSI 223例)的临床资料。根据精子DNA碎片指数(DFI)分为正常组(DFI<10%)、轻度DFI组(10%≤DFI<20%)和重度DFI组(DFI≥20%),分别比较了IVF和ICSI中三组的受精率、卵裂率、可用胚胎率、优质胚胎率和临床妊娠率。结果在IVF周期中,DFI对受精率、卵裂率、可用胚胎率、优质胚胎率和临床妊娠率均无影响(P>0.05);在ICSI周期中,DFI对受精率和卵裂率无影响(P>0.05),但可用胚胎率和优质胚胎率三组之间有显著性差异(P<0.05),临床妊娠率虽然随着DFI的增高而下降,却无显著相关性(P>0.05)。结论精子DNA碎片对IVF结局基本无影响,但与ICSI结局中的可用胚胎率和优质胚胎率呈负相关,这可能与受精过程中IVF周期中卵子对精子有自然选择的过程,而ICSI周期中则是人为的选择精子有关。Objective：To explore the relationship between sperm DNA fragmentation and the outcome of in vitro fertilization（IVF）/intracytoplasmic sperm injection（ICSI）. Methods：Retrospective analysis based on 725 couples who accepted IVF/ICSI.According to the test results of DFI,the cases were divided into normal group（DFI〉10%）,low DFI group（10%≤DFI〈20%）and high DFI group（DFI≥20%）.The relationship between sperm DNA fragmentation index（DFI）and the fertilization rate,embryo cleavage rate,available embryo formation rate,good quality embryo formation rate and clinical pregnancy rate of three groups were compared after the cases were treated with IVF/ICSI. Results：In cases treated by IVF,there is no significant correlation of sperm DFI with the fertilization rate,embryo cleavage rate,available embryo formation rate,good quality embryo formation rate and clinical pregnancy rate（P〉0.05）.In cases treated by ICSI,there is no significant correlation of sperm DFI with the fertilization rate and embryo cleavage rate（P〉0.05）,but the correlation of sperm DFI with the available embryo formation rate and good quality embryo formation rate is significant（P〈0.05）. The clinical pregnancy rate was decreased with the increase of DFI,but there is no significant correlation with sperm DFI（P〉0.05）. Conclusion：The DFI has no any effect on the outcomes of IVF.But there is a negative correlation with the available embryo formation rate and good quality embryo formation rate in the ICSI outcomes.The probable reason is the natural selection during sperm-egg binding in IVF cycle during fertilization,while the best sperm evaluated in morphology was picked up by embryologists when doing ICSI,but some types of damage may be not seen.

关 键 词：精子DNA碎片指数 体外受精 卵胞浆内单精子注射 

分 类 号：R321-33[医药卫生—人体解剖和组织胚胎学]