取卵当日男方精液参数对体外受精-胚胎移植出生结局的影响  

Male semen parameters on the day of oocyte retrieval impact on live birth outcomes of IVF-ET

作　　者：朱宏 杨岳洲 余敏[2] 彭献东[2] 陈颖[2] 汤晓峰[2] 江峰[2] Zhu Hong;Yang Yuezhou;Yu Min;Peng Xiandong;Chen Ying;Tang Xiaofeng;Jiang Feng(Obstetrics&Gynecology Hospital of Fudan University,Shanghai 200011,China;Shanghai JiAi Genetics&IVF Institute China-USA Center,Shanghai 200011,China)

机构地区：[1]复旦大学附属妇产科医院,上海200011 [2]上海集爱遗传与不育诊疗中心,上海200011

出　　处：《中国男科学杂志》2021年第2期24-26,49,共4页Chinese Journal of Andrology

基　　金：上海市市级科技重大专项“国际人类表型组计划(一期)”(项目编号:2017SHZDZX01)。

摘　　要：目的探讨体外受精-胚胎移植技术(IVF-ET)中男方精液参数对出生结局的影响。方法回顾分析1374例因女方输卵管因素不孕行IVF-ET助孕的出生结局,分为活产组、流产组及未着床组,比较各组间年龄、体重指数及取卵当日男方精液参数的差异。将所有研究对象根据前向运动精子(PR)比例由高至低分为五组,比较各组间活产率、流产率、孕周、出生体重及二胎出生体重。采用二元Logistic回归进行是否获得活产的多因素分析,比较各精液参数对出生结局的预测价,P<0.05被认为差异存在统计学意义。结果活产组精子浓度高于未着床组(P <0.05)、PR比例显著高于流产组及未着床组(P<0.01)。随着PR比例增高、活产率显著增高(P<0.01)。相较PR≥50%组,PR≤25%组孕周数更短(P<0.05)、PR在40%以下各组二胎出生体重更低(P<0.05)。二元Logistic回归分析显示PR比例是能否获得活产婴儿的独立危险因素(P<0.01)。结论取卵当日男方精子活力是影响IVF-ET出生结局的重要因素,PR精子比例越高、活产率相对越高。Objective To investigate the influence of male sperm parameters on live birth outcomes of in vitro fertilization and embryo transfer(IVF-ET). Methods The live birth outcomes of 1,374 couples were retrospectively analyzed,which were divided into the live birth group, the abortion group and the non-implantation group, for exploring the influence of male semen parameters on live birth outcomes on the day of IVF-ET oocyte retrieval. All the subjects were divided into five groups according to the progressive motility sperm(PR) ratio from the highest to the lowest. The live birth rate, miscarriage rate, gestational age, birth weight and second birth weight were compared among the groups. The multivariate analysis of live birth was performed by binary Logistic regression, and the predictive value of semen parameters on birth outcome was compared. P<0.05 was considered statistically significant. Results Sperm concentration in the live birth group was higher than that in the non-implantation group(P<0.05), PR ratio was significantly higher than that of the abortion group and the non-implantation group(P<0.01). With the increase of PR ratio, the live birth rate increased significantly(P<0.01). Compared with the PR≥50% group, the gestational age of the PR≤25% group was shorter(P<0.05), and the second birth weight of the PR< 40% group was lower(P<0.05). Binary Logistic regression analysis showed that PR ratio was an independent risk factor for live birth(P<0.01). Conclusion Male sperm parameters on the day of IVF oocyte retrieval had a significant impact on live birth outcomes. The higher the proportion of PR sperm, the higher the live birth rate.

关 键 词：体外受精 胚胎移植技术 妊娠结局 精液参数 

分 类 号：R321-33[医药卫生—人体解剖和组织胚胎学]