精子DNA碎片指数与单精子显微注射妊娠结局的相关性分析  

Association between sperm DNA fragmentation index and ICSI pregnancy outcome

作　　者：于晓光[1] 赵媛媛 黄珊 郝婉姣 王娜[1] YU Xiaoguang;ZHAO Yuanyuan;HUANG Shan;HAO Wanjiao;WANG Na(Department of Reproductive Medicine, Baoding Maternal and Child Health Hospital, Baoding 071000, China;Department of Reproductive Medicine, Affiliated Hospital of Hebei University, Baoding 071000, China)

机构地区：[1]保定市妇幼保健院生殖医学科,河北保定071000 [2]河北大学附属医院生殖医学科,河北保定071000

出　　处：《医学研究与教育》2021年第6期15-21,共7页Medical Research and Education

基　　金：保定市科学技术研究与发展计划项目(17ZF033)。

摘　　要：目的分析精子DNA碎片指数(DNA fragmentation index,DFI)对接受卵胞浆内单精子显微注射(Intracytoplasmic sperm injection,ICSI)助孕后冷冻胚胎移植后的临床妊娠率的影响。方法回顾性分析接受ICSI助孕的87对夫妇的一般资料,排除女性因素不孕与夫妇双方染色体结构异常和男性Y染色体微缺失,对不同DFI男性患者进行分组,并对2组患者睾丸体积(超声多普勒)、血清促卵泡素(follicle stimulating hormone,FSH)等激素、精液常规分析、精子DFI和临床妊娠率进行统计学分析。结果不同DFI患者组的女方年龄、男方年龄、不孕时间、冷冻解冻胚胎移植(Frozen embryo transfer,FET)日雌二醇(E2)、FET日子宫内膜厚度等差异无统计学意义;DFI≤25%组的受精率、双原核(2 Pronucleus,2PN)形成率、卵裂率、优质胚胎率、囊胚形成率分别为80.92%、85.37%、96.34%、23.56%、31.78%,DFI>25%组分别为70.51%、71.71%、88.05%、11.30%、14.14%,上述各指标DFI≤25%组均大于DFI>25%组且差异有统计学意义。DFI≤25%组的临床妊娠率(45.24%)大于DFI>25%组(20.00%),且差异有统计学意义(χ^(2)=6.340,P=0.012)。结论精子DFI与妊娠结局密切相关,异常升高的精子DFI(DFI>25%)将对临床妊娠率产生不利影响。Objective To investigate the effects of DNA fragmentation index(DFI)on the clinical pregnancy rate of frozen-thawed embryo transfer(FET)after intracytoplasmic sperm injection(ICSI).Methods The general data of 87 couples who received ICSI for assisted reproductive technology were retrospectively analyzed.Female infertility,chromosomal structural abnormalities of both couples and male Y chromosome microdeletion were excluded.Testicular volume(Ultrasound Doppler)assessment,serum FSH and TT tests,routine semen analysis,percentage of sperm DNA fragments,and clinical pregnancy rates were statistically analyzed.Results There were no significant differences in female age,male age,infertility years,estradiol(E2)on FET day,intrauterine thickness on FET day.There were significant differences between DFI≤25%and DFI>25%group on fertilization rate(80.92%vs 70.51%),2PN formation rate(85.37%vs 71.71%),cleavage rate(96.34%vs 88.05%),high quality embryo rate(23.56%vs 11.30%),blastocyst formation rate(31.78%vs 14.14%).The clinical pregnancy rate(45.24%)in DFI≤25%group was higher than that in DFI>25%group(20.00%)and the difference was statistically significant(χ2=6.340,P=0.006).Conclusion Studies show that sperm DFI is closely related to pregnancy outcome,and the unusually high sperm DFI can affect the clinical pregnancy rate adversely.

关 键 词：精子功能 精子质量 妊娠结局 精子DNA碎片指数 

分 类 号：R69[医药卫生—泌尿科学]