不同来源精子DNA碎片指数、顶体完整性与卵胞浆内单精子注射技术助孕结局相关性分析  

Correlation analysis of DNA fragmentation index,acrosome integrity of sperm from different sources and the pregnancy outcome of intracytoplasmic sperm injection technique

作　　者：殷晨星[1] 李澎涛[1] 于晓光[1] 邢鹏[1] 王娜[1] 师楠 孟娜娜 王玉真[1] YIN Chenxing;LI Pengtao;YU Xiaoguang;XING Peng;WANG Na;SHI Nan;MENG Nana;WANG Yuzhen(Department of Reproductive Medicine,Baoding Maternal and Child Health Hospital,Baoding Hebei 071000,P.R.China)

机构地区：[1]保定市妇幼保健院生殖医学科,河北保定071000

出　　处：《中国计划生育和妇产科》2021年第4期42-45,共4页Chinese Journal of Family Planning & Gynecotokology

基　　金：保定市科技计划项目(项目编号:1951ZF084)。

摘　　要：目的探讨不同来源精子及其DNA碎片指数(DNA fragmentation index,DFI)和顶体完整性对卵胞浆内单精子注射技术(intracy toplasmic sperm injection,ICSI)受精和妊娠结局的影响。方法回顾性分析2017年5月至2020年5月因男性不育于保定市妇幼保健院行ICSI的185个新鲜周期,按精子来源分为3组。A组:诊断为严重少弱精子症的男性患者的射出精液(95个周期);B组:睾丸取精精子(57个周期);C组:附睾取精精子(33个周期)。比较并分析3组精子DNA碎片率(用精子DFI表示)、顶体完整性的差异及对ICSI周期的2PN率、2PN卵裂率、优胚率和妊娠率的影响。结果3种来源的精子ICSI周期中,B组DNA碎片率显著低于A组和C组(P<0.05);3组间顶体完整性差异无统计学意义(P>0.05)。A组、B组的2PN率高于C组,A组的2PN卵裂率、优胚率明显高于B、C组(P<0.05);3组妊娠率比较差异无统计学意义(P>0.05)。结论睾丸、附睾取精与严重少弱精子症患者手淫取精行ICSI的妊娠结局无统计学差异;睾丸精子DFI小于附睾精子,严重少弱精子症患者手淫精子和睾丸精子的受精结局好于附睾精子。Objective To explore the effects of DNA fragmentation index(DFI)and acrosome integrity of sperm from different sources on the fertilization and pregnancy outcome of intracy toplasmic sperm injection(ICSI).Methods A retrospective analysis of 185 fresh cycles of ICSI in Baoding Maternal and Child Health Hospital from May 2017 to May 2020 due to male infertility was divided into 3 groups according to the source of sperm.Group A:ejaculated semen from male patients diagnosed with severe oligoasthenospermia(95 cycles);Group B:sperm from the testis(57 cycles);Group C:sperm from the epididymis(33 cycles).The differences in sperm DNA fragmentation rate(indicated by sperm DFI),acrosome integrity of 3 groups,and their influence on the 2 PN rate,2 PN cleavage rate,excellent embryo rate and pregnancy rate of the ICSI cycle were compared and analyzed.Results In the ICSI cycle of sperm from three sources,the DNA fragmentation rate of group B was significantly lower than that of group A and group C(P<0.05);there was no significant difference in acrosome integrity between the three groups(P>0.05).The 2 PN rate of group A and group B was higher than that of group C.The 2 PN cleavage rate and excellent embryo rate of group A were significantly higher than those of group B and C(P<0.05);there was no statistically significant difference in pregnancy rate between the three groups(P>0.05).Conclusion There are no statistically significant differences in pregnancy outcomes of ICSI between testis and epididymal sperm retrieval and masturbation of severe oligoasthenospermia patients;the DFI of testicular sperm is less than that of epididymal sperm,and the fertilization outcome of masturbated sperm and testicular sperm in patients with severe oligoasthenospermia was better than that of epididymal sperm.

关 键 词：严重少弱精子症 DFI 顶体完整性 ICSI 

分 类 号：R6982[医药卫生—泌尿科学]