使用不同来源精子行卵胞浆内单精子注射对受精、胚胎发育及妊娠结局的影响  

Effects of intracytoplasmic sperm injection with sperms from different sources on fertilization,embryonic development and pregnancy outcomes

作　　者：张小慧[1] 黄悦悦[1] 王世凯[1] 谭卫红[1] 毛献宝[1] 李政达 周亭亭 韦娉嫔 刘庆友 薛林涛[1] ZHANG Xiao-hui;HUANG Yue-yue;WANG Shi-kai;TAN Wei-hong;MAO Xian-bao;LI Zheng-da;ZHOU Ting-ting;WEI Ping-pin;LIU Qing-you;XUE Lin-tao(Reproductive Medical and Genetic Center,the People′s Hospital of Guangxi Zhuang Autonomous Region,Nanning 530021,China)

机构地区：[1]广西壮族自治区人民医院生殖医学与遗传中心

出　　处：《广西医学》2019年第23期2949-2952,2957,共5页Guangxi Medical Journal

基　　金：国家自然科学基金(31860638);广西医药卫生科研课题(Z2015305);广西南宁市青秀区科技计划(2018025)

摘　　要：目的探讨使用不同来源精子行卵胞浆内单精子注射(ICSI)对受精、胚胎发育及临床妊娠结局的影响。方法回顾性分析接受ICSI治疗的703对不育夫妇的资料,根据精子来源分为正常精液组(A组)56例、少弱精子症组(B组)364例、附睾精子组(C组)187例和睾丸精子组(D组)96例。比较4组精子DNA碎片率、精子顶体完整率、正常受精率、胚胎发育参数及临床妊娠结局。结果A组与B组DNA碎片率低于C组与D组,且顶体完整率高于C组与D组(均P<0.05)。A组的正常受精率高于B组、C组与D组,且B组的正常受精率高于C组(均P<0.05)。B组的优质胚胎率、囊胚形成率和可冻囊胚形成率低于D组(均P<0.05)。4组的正常卵裂率、优质囊胚形成率、胚胎种植率、临床妊娠率、流产率、活产率、男女婴比例差异均无统计学意义(均P>0.05)。结论使用不同来源精子行ICSI治疗,会导致精子DNA碎片率和顶体完整率存在差异,从而影响正常受精率;少弱精子症来源的精子可影响ICSI治疗周期胚胎发育结局。Objective To investigate the effects of intracytoplasmic sperm injection(ICSI)using sperms from different sources on fertilization,embryonic development and pregnancy outcomes.Methods Data of 703 infertile couples undergoing ICSI were analyzed retrospectively,and the cases were assigned into normal semen group(group A,n=56),oligozoospermia asthenospermia group(group B,n=364),epididymal sperm group(group C,n=187),or testicular sperm group(group D,n=96)in accordance with sperm source.The rate of sperm DNA fragmentation,rate of sperm acrosome integrity,normal fertilization rate,parameters of embryonic development and clinical pregnancy outcomes were compared between the four groups.Results Group A and group B obtained a lower rate of DNA fragment and a higher rate of sperm acrosome integrity as compared with group C and group D(all P<0.05).The normal fertilization rate of group A was higher than that of group B,group C or group D,and the normal fertilization rate of group B was higher than that of group C(all P<0.05).The rate of high-quality embryo,formation rates of blastocyst and freezable blastocyst were lower in group B as compared with group D(all P<0.05).There were no statistically significant differences in the rate of normal cleavage,formation rate of high-quality blastocyst,rate of embryo implantation,clinical pregnancy rate,miscarriage rate,live birth rate and gender ratio of newborns among the four groups(all P>0.05).Conclusion ICSI using sperms from different sources can cause the differences in the rates of sperm DNA fragment and acrosome integrity,and thereby affecting the normal fertilization rate;the sperms derived from oligozoospermia and asthenospermia may impact on the outcomes of embryo development in ICSI cycle.

关 键 词：卵细胞浆内单精子注射 精子来源 精子参数 正常受精率 胚胎发育 临床妊娠 

分 类 号：R321.1[医药卫生—人体解剖和组织胚胎学]