精子DFI与精液常规、精子形态学的相关性及其对IVF-ET/ICSI结局的影响  

Correlation analysis of sperm DFI,semen routine and sperm morphology and the effect of sperm DFI on IVF-ET/ICSI outcome

作　　者：查晓敏 朱复希[1] 张静静[1] 徐元宏[1] ZHA Xiao-min;ZHU Fu-xi;ZHANG Jing-jing;XU Yuan-hong(The First Affiliated Hospital of Anhui Medical University,Hefei 230022,China)

机构地区：[1]安徽医科大学第一附属医院,230022

出　　处：《天津医药》2021年第1期45-49,共5页Tianjin Medical Journal

基　　金：安徽省重点研究与开发计划项目(9021138206);安徽省杰出青年科学基金(1908085J28);安徽省重点研究和开发计划(201904a07020050)。

摘　　要：目的分析精子DNA碎片指数(DFI)与精液常规、精子形态学及体外受精-胚胎移植(IVF-ET)/卵胞浆内单精子注射(ICSI)结局的关系,探讨精子DFI预测男性生育力及IVF-ET/ICSI结局的价值。方法回顾性分析2420例男性不育患者精液检查数据,根据DFI值分为A组(DFI≤15%)、B组(15%<DFI<30%)、C组(DFI≥30%),分析精子DFI与精液常规、精子形态学相关性。检测117对IVF-ET/ICSI不孕夫妇中男性患者精子DFI,精液常规、精子形态学,根据DFI值分为IVF-1组(DFI≤15%)、IVF-2组(15%<DFI<30%)、IVF-3组(DFI≥30%),ICSI-1组(DFI≤15%)、ICSI-2组(15%<DFI<30%)、ICSI-3组(DFI≥30%),研究精子DFI对IVF-ET/ICSI结局的影响。结果A、B、C组患者年龄、精子畸形率逐次升高,精子浓度、前向运动精子(PR)、精子活动率逐次降低(P<0.01);精子DFI与年龄、精子畸形率呈正相关,与精子浓度、PR、精子活动率呈负相关(P<0.01);与IVF-1组比较,IVF-3组精子浓度、PR降低;IVF-3组精子畸形率较IVF-2组升高;与ICSI-1组和ICSI-2组比较,ICSI-3组PR降低;ICSI-3组精子畸形率较ICSI-1组升高(P<0.05);IVF组和ICSI组中,各亚组受精率、卵裂率、优胚率及临床妊娠率差异均无统计学意义(P>0.05)。结论精子DFI可有效评估男性生育力。精子DFI对IVF/ICSI的临床结局没有预测价值,不建议将精子DFI检测作为选择辅助生殖技术方案检查项目。Objective To analyze the relationship between sperm DNA fragmention index(DFI)and semen routine,sperm morphology and in vitro fertilization embryo transfer(IVF-ET)/intracytoplasmic sperm injection(ICSI)outcome,and to explore the predictive value of sperm DFI in evaluating male fertility and the outcome of IVF-ET/ICSI.Methods Data of the sperm DFI,sperm routine and sperm morphology data of 2420 male infertility patients,according to DFI level,the patients were divided into three groups:Group A,Group B(15%<DFI<30%),Group C(DFI≥30%),the correlation between sperm DFI and semen routine,malformation rate was analyzed.Sperm DFI,semen routine and sperm morphology was detected in male patients of 117 pairs of IVF-ET/ICSI infertile couples,then subdivided into IVF-1 group(DFI≤15%),IVF-2 group(15%<DFI<30%),IVF-3 group(DFI≥30%),ICSI-1 group(DFI≤15%),ICSI-2 group(15%<DFI<30%)and ICSI-3 group(DFI≥30%)according to DFI value.The effect of sperm DFI on the outcome of IVF-ET/ICSI was analyzed.Results The age,sperm malformation rate of patients were successively increased in group A,group B and group C,while sperm concentration,PR and sperm motility rate was successively decreased(P<0.01).The sperm DFI was positively correlated with patient age and sperm malformation rate,and the sperm DFI was negatively correlated with sperm concentration,PR and sperm motility rate(P<0.01).Compared with IVF-1 group,the sperm concentration and PR were decreased in IVF-3 group.The sperm malformation rate was higher in IVF-3 group than that in IVF-2 group.Compared with ICSI-1 group and ICSI-2 group,the PR was decreased in ICSI-3 group.The sperm malformation rate was higher in ICSI-3 group than that of ICSI-1 group(P<0.05).There were no statistically significant differences in fertilization rate,cleavage rate,embryo rate and clinical pregnancy rate between IVF group or ICSI group,and between all subgroups(P>0.05).Conclusion Sperm DFI can be used to evaluate male fertility effectively.Sperm DFI has no predictive value for IVF-ET/ICSI clinical

关 键 词：精子 精液分析 体外受精 胚胎移植 妊娠结局 不育 男(雄性) DNA碎片指数 卵胞浆内单精子注射 精子染色质结构分析 

分 类 号：R698.2[医药卫生—泌尿科学]