精子DNA损伤对IVF/ICSI-ET生殖结局的影响  

Effect of sperm DNA damage on IVF/ICSI-ET reproductive outcome

作　　者：冼卓杰[1] 董玲凤 黄建洲[1] 池霖生[1] XIAN Zhuo-jie;DONG Ling-feng;HUANG Jian-zhou;CHI Lin-sheng(Foshan Maternal and Child Health Care Hospital,Foshan,Guangdong 528000,China)

机构地区：[1]佛山市妇幼保健院生殖中心

出　　处：《中国优生与遗传杂志》2019年第10期1262-1263,1280,共3页Chinese Journal of Birth Health & Heredity

摘　　要：目的探讨在不同精子DNA碎片率(DFI)对常规体外受精胚胎移植(IVF-ET)周期和卵胞浆内单精子注射胚胎移植(ICSI-ET)周期结局的影响。方法收集本中心2018年7月至2019年3月共725例临床资料(IVF-ET 339个周期,ICSI-ET 326个周期)。根据精子DNA碎片分为三组(<15%,15%-30%,≥30%),分别比较IVF-ET和ICSI-ET三组中受精率、卵裂率、优质胚胎率、临床妊娠率。结果两种授精方式,受精率、优质胚胎率、临床妊娠率均随着DFI升高而降低,其中当DFI≥30%时,IVF-ET和ICSI-ET的受精率均明显低于其余两组(P<0.05);在ICSI-ET中,当DFI≥30%时,临床妊娠率低于DFI<15%组(P<0.05)。当DFI<30%时,IVF-ET受精率高于ICSI-ET受精率,具有统计学差异(P<0.05)。结论精子DNA碎片率的升高对IVF-ET和ICSI-ET均有不利的影响,DNA碎片升高对IVF-ET的影响比较ICSI-ET小。可能由于IVF受精时对精子的要求比较高,起到一个筛选的作用。精子DNA碎片率对ART的受精率、优胚率、临床妊娠率均有一定的指导意义。Objective:To investigate the effects of different sperm DNA fragmentation rate(DFI)on the cycle of conventional in vitro fertilization embryo transfer(IVF-ET)and intracytoplasmic sperm injection(ICSI-ET).Methods:A total of 725 clinical data were collected from July 2018 to March 2019(IVF-ET 339 cycles,ICSI-ET 326 cycles).According to sperm DNA fragments,they were divided into three groups(<15%,15%-30%,≥30%).The fertilization rate,cleavage rate,high quality embryo rate and clinical pregnancy rate were compared between IVF-ET and ICSI-ET.Results:Both fertilization rates,high quality embryo rate and clinical pregnancy rate decreased with the increase of DFI.When DFI≥30%,the fertilization rates of IVF-ET and ICSI-ET were significantly lower than the other two groups.(P<0.05);in ICSI-ET,when DFI≥30%,the clinical pregnancy rate was lower than the DFI<15%group(P<0.05).When DFI<30%,IVF-ET fertilization rate was higher than ICSI-ET fertilization rate,with statistical difference(P<0.05).Conclusion:The increase of sperm DNA fragment rate has adverse effects on IVF-ET and ICSI-ET.The effect of DNA fragmentation on IVF-ET is smaller than ICSI-ET.It may be due to the high requirement of sperm in IVF fertilization,which plays a screening role.Sperm DNA fragmentation rate has a certain guiding significance for ART fertilization rate,excellent embryo rate and clinical pregnancy rate.

关 键 词：精子DNA碎片 IVF-ET ICSI-ET 

分 类 号：R321-33[医药卫生—人体解剖和组织胚胎学]