精子正常形态率、顶体完整率及顶体反应率与补救ICSI结局相关性研究  

Relationship between normal sperm morphology rate,sperm acrosome integrity rate,acrosome reaction rate and outcome of rescue ICSI

作　　者：陈其桂 李大文 谭卫红[2] 成俊萍[2] 薛林涛[2] 李金燕[3] 何泳志 庞太森 韦福 黄泰帅 CHEN Qi-gui;LI Da-wen;TAN Wei-hong;CHENG Jun-ping;XUE Lin-tao;LI Jin-yan;HE Yong-zhi;PANG Tai-sen;WEI Fu;HUANG Tai-shuai(Guangxi Medical University,Nanning 530021;Center for Reproductive Medicine&Genetics,People’s Hospital of Guangxi Zhuang Autonomous Region,Nanning 530021;Guilin Medical University,Guilin 541004;Reproductive Medicine Center,Maternal&Child Health Hospital of Guangxi Zhuang Autonomous Region,Nanning 530003)

机构地区：[1]广西医科大学,南宁530021 [2]广西壮族自治区人民医院生殖医学与遗传中心,南宁530021 [3]桂林医学院,桂林541004 [4]广西壮族自治区妇幼保健院生殖中心,南宁530003

出　　处：《生殖医学杂志》2020年第12期1581-1586,共6页Journal of Reproductive Medicine

基　　金：国家自然科学基金(81360107);广西自然科学基金(2019GXNSFAA185056);广西壮族自治区卫生和计划生育委员会自筹经费科研课题(Z20170376)。

摘　　要：目的分析精子正常形态率、顶体完整率及顶体反应率与补救卵胞浆内单精子注射(补救ICSI)结局的相关性。方法回顾性分析2014年1月至2018年12月期间在广西壮族自治区人民医院生殖医学与遗传中心行常规IVF失败需行补救ICSI的125对不孕夫妇的临床资料。根据妊娠情况分为妊娠组(n=56)及未妊娠组(n=69),比较两组患者的基本情况、精液常规参数及受精移植情况;采用Spearman等级分析精子正常形态率、顶体完整率及顶体反应率与补救ICSI结局的相关性。结果两组患者的基本资料及精液常规参数均无显著性差异(P>0.05)。行补救ICSI后两组患者的受精率、卵裂率、优胚率也均无显著性差异(P>0.05),但妊娠组优质胚胎数显著高于未妊娠组(P<0.05)。Spearman等级分析结果显示:精子正常形态率与受精率、卵裂率存在显著相关性(P<0.05),与优胚率无显著相关性(P>0.05);精子顶体完整率与优胚率存在显著相关性(P<0.05),与受精率、卵裂率均无显著相关性(P>0.05);精子顶体反应率与受精率、卵裂率及优胚率均无显著相关性(P>0.05)。在补救ICSI周期中,临床妊娠率为44.80%(56/125),活产率为39.20%(49/125),包括单胎31例和双胎18例。结论补救ICSI可获得较好的临床妊娠结局,是IVF受精失败后不错的选择方案,优胚数与其妊娠结局相关,精子正常形态率、顶体完整率是影响胚胎发育的重要因素。Objective:To analyze the correlation between normal sperm morphology rate,sperm acrosome integrity rate,acrosome reaction rate and outcome of rescue intracytoplasmic sperm injection(rescue ICSI).Methods:This retrospective analysis was conducted among 125 infertile couples received rescue ICSI due to IVF failure in the Reproductive Medicine and Genetics Center of the People’s Hospital of Guangxi Zhuang Autonomous Region from January 2014 to December 2018.According to the pregnancy outcome,the patients were divided into pregnancy group(n=56)and non-pregnancy group(n=69).The general clinical data,semen parameters and fertilization and transplantation status of the two groups were compared.The correlation between the normal sperm morphology rate,sperm acrosome integrity rate,acrosome reaction rate and the ICSI outcome was analyzed by using Spearman rank analysis.Results:There was no significant difference in general clinical data and semen quality between the two groups(P>0.05).There was no significant difference in the fertilization rate,cleavage rate and the good-quality embryo rate after received rescue ICSI between the patients of two groups(P>0.05).However,the number of good-quality embryos in the pregnancy group was significantly higher than that in the non-pregnancy group(P<0.05).The results of Spearman rank analysis showed that the normal sperm morphology rate was significantly correlated with the fertilization rate and cleavage rate(P<0.05),but not correlated with the good-quality embryo rate(P>0.05).The sperm acrosome integrity rate was significantly correlated with the good-quality embryo rate(P<0.05),but not correlated with the fertilization rate and cleavage rate(P>0.05).There was no significant correlation between the sperm acrosome reaction rate and the fertilization rate,cleavage rate,good-quality embryo rate(P>0.05).In the rescue ICSI cycle,the clinical pregnancy rate was 44.80%(56/125),the live birth rate was 39.20%(49/125),including 31 singletons and 18 twins.Conclusions:The rescue ICSI can have

关 键 词：精子正常形态率 精子顶体完整率 精子顶体反应率 补救卵胞浆内单精子注射 结局 

分 类 号：R698.2[医药卫生—泌尿科学]