不同参数精子顶体酶活性与精子在IVF治疗中受精能力的关系研究  

Study on the relationship between the acrosin activity of sperm with different parameters and the fertilization ability of sperm in IVF treatment

作　　者：冯星 叶红 胡元波 汤佳楠 王志凯 孙予华 顾一骅[2] 郑菊芬 Xing Feng;Hong Ye;Yuanbo Hu;Jianan Tang;Zhikai Wang;Yuhua Sun;Yihua Gu;Jufen Zheng(Clinical Laboratory of Shanghai Family Planning Hospital,Shanghai 200032,China;Key Lab.of Reproduction Regulation of NPFPC,Shanghai Institute of Planned Parenthood Research,Shanghai 200032;Reproductive Center of the First Affiliated Hospital of Naval Military Medical University,Shanghai 200433,China)

机构地区：[1]海市计生所医院检验科,上海200032 [2]上海市计划生育科学研究所,国家人口和计划生育避孕药具重点实验室,上海200032 [3]海军军医大学第一附属医院生殖中心,上海200433

出　　处：《中国男科学杂志》2019年第4期29-34,共6页Chinese Journal of Andrology

基　　金：上海市卫生计生委委基金项目(编号:201440002)

摘　　要：目的探讨不同参数精子的顶体酶活性与精子在体外受精(IVF)治疗中受精能力的关系。方法通过对75 例接受IVF或短时IVF治疗的少弱精子或正常精子病例进行术前精子顶体酶活性测定,不明原因和有受精不良史病例优先入组。比较顶体酶正常值组和低值组的精子参数差异和IVF受精结果;进一步比较精子高浓度组(>35×10^6/mL)和低浓度组[(10-35)×10^6/mL]的顶体酶活性值差异和IVF受精结果。结果顶体酶活性正常值组和低值组的精子浓度分别为(61.88±35.95)×10^6/mL和(32.89±12.94)×10^6/mL,两者差异具统计学意义(P<0.01),前向运动精子百分率分别为(48.76±12.60)%和(36.35±10.30)%,差异无统计学意义(P>0.05),快速前向运动精子百分率分别为(22.41 ±7.02)%和(16.35+5.23)%,差异无统计学意义(P>0.05), IVF或短时IVF总受精率分别为67.65%和41.74%,两者差异具统计学意义(P<0.01),不受精率分别为19.51%和38.24%,差异无统计学意义(P>0.05),低受精率0%VS14.71%(P<0.05)。精子高浓度组和低浓度组的精子顶体酶活性值分别为(76.55+32.65) VS (43.17±19.68)(M0.01), IVF或短时IVF总受精率 70.65% VS41.20%(P<0.01),不受精比例 17.95%(7/39) VS 3&89%(14/36)(P>0.05),低受精比例 0%(0/39)VS 13.89%(5/36)(P<0.05)。精子高浓度组完全不受精病例卵子数均大于6枚,没有低受精病例,顶体酶异常占12.8%(5/39),其中只有1例不受精;而精子低浓度组完全不受精病例大部分卵子数少于6枚,顶体酶异常占80.56%(29/36),其中不受精和低受精率为58.62%(17/29)。结论在IVF治疗中,粗子浓度与受精能力的相关性比活动力和顶体酶活性更强;在低浓度组通常伴有顶体酶活性的低下,提示低受精或不受精可能性增大;而高浓度精子顶体酶大多正常,呈现“全”或“无”的受精模式,其不受精原因可能与顶体酶活性无关。Objective To investigate the relationship between the acrosin activity of sperm with different parameters and the fertilization ability of sperm in IVF treatment. Methods Preoperative sperm acrosome enzyme activity was measured in 75 cases of oligospermia or normal sperm treated with IVF or short-term IVF. Cases with unexplained and poorly fertilized cases were prioritized. Comparison of sperm parameter differences and IVF fertilization results between the normal and low value groups of acrosome enzymes;further comparison of acrosin activity in high sperm concentration group (>35 ×10^6 /mL) and low concentration group (10-35×10^6 /mL) Value difference and IVF fertilization results. Results The sperm concentration in the normal and low value groups of acrosome enzyme activity was 61.88+35.95 VS 32.89±12.94 (P<0.01), and the percentage of forward moving sperm was 48.76±12.60 VS 36.35±10.30(P>0.05). The percentage of sperm in the forward movement was 22.41 土 7.02 VS 16.35±5.23(P>0.05), the total fertilization rate ofIVF or short-term IVF was 67.65% VS 41.74%(P<0.01), and the accuracy was 19.51% VS 38.24%(P>0.05).), low fertilization rate 0% VS 14.71%(P<0.05). The sperm acrosome activity values of sperm high concentration group and low concentration group were 76.55±32.65 VS 43.17±19.68 (P<0.01), IVF or short-term IVF total fertilization rate was 70.65% VS 41.20%(P<0.01), not refined. The ratio was 17.95%(7/39) VS 38.89%(14/36)(P>0.05), and the low fertilization ratio was 0%(0/39) vs 13.89%(5/36)(P<0.05). In the high concentration group of sperm, the number of eggs in the sperm case was more than 6, and there was no case of low fertilization. The acrosome enzyme abnormality accounted for 12.8%(5/39), of which only 1 case was not refined;while the low sperm concentration group was completely unaffected by the sperm case. The number of partial eggs was less than 6 and the acrosome enzyme abnormality accounted for 80.56%(29/36), of which the unfertilized and low fertilization rate was 58.62%(17/29). Conclusion

关 键 词：顶体酶活性 精子 受精 精子注射 细胞质内 不育 男性 

分 类 号：R714.8[医药卫生—妇产科学]