精子DNA损伤对胚胎卵裂模式及胚胎发育的影响  

Effects of sperm DNA damage on embryo cleavage pattern and development

作　　者：朱家红 高洋[1] 付涛 邹佳益 魏彪 韩伟[1,2] 黄国宁 ZHU Jia-hong;GAO Yang;FU Tao;ZOU Jia-yi;WEI Biao;HAN Wei;HUANG Guo-ning(Reproductive Medicine Center,Chongqing Health Center for Women&Children,Chongqing 400013;Chongqing Key Laboratory of Human Embryo Engineering,Chongqing 400013)

机构地区：[1]重庆市妇幼保健院生殖医学中心,重庆400013 [2]人类胚胎工程重庆市重点实验室,重庆400013

出　　处：《生殖医学杂志》2022年第4期441-446,共6页Journal of Reproductive Medicine

基　　金：重庆市妇幼保健院院级青年培育项目(2020YJQN09)。

摘　　要：目的探讨精子DNA损伤对胚胎早期卵裂模式及胚胎发育的影响。方法回顾性分析2020年1月至2021年6月于重庆市妇幼保健院生殖医学中心接受不孕不育症治疗的432对不孕不育夫妇的临床资料,共432个取卵周期(其中224个周期行鲜胚移植)。将纳入患者根据授精方式不同分为IVF组和ICSI组,每组又按照精子DNA碎片指数(DFI)不同分为DFI<15%和DFI≥15%亚组,即ICSI DFI<15%组(83例)、ICSI DFI≥15%组(105例)和IVF DFI<15%组(153例)、IVF DFI≥15%组(91例)。比较各组的一般资料、精液参数、胚胎发育情况及妊娠结局。结果(1)ICSI和IVF周期中DFI亚组间女方年龄、体质量指数(BMI)、抗苗勒管激素(AMH)、FSH、LH水平及Gn用量和天数均无显著性差异(P>0.05),但DFI<15%亚组精子总活力和浓度均显著高于DFI≥15%亚组(P<0.05)。(2)胚胎发育方面,ICSI和IVF周期中DFI亚组间获卵数、MⅡ卵数、2PN受精率、D3可利用胚胎数、正常卵裂模式胚胎率及优质囊胚率均无显著性差异(P>0.05),但囊胚形成率在DFI<15%组均显著高于DFI≥15%组(ICSI周期69.57%vs.61.09%;IVF周期65.58%vs.57.28%;P<0.05)。(3)鲜胚移植结局方面,ICSI和IVF周期中DFI亚组间平均移植胚胎数、平均移植优质胚胎数及正常卵裂模式胚胎数均无显著性差异(P>0.05),临床妊娠率、种植率和流产率亦无显著性差异(P>0.05)。(4)Spearman相关性分析显示,精子DFI与正常卵裂模式胚胎率无显著相关性(P>0.05),但与囊胚形成率呈显著负相关(r=-0.562,P=0.029)。结论精子DFI高低与男性的精子浓度和活力相关;胚胎的早期卵裂模式可能不会受到精子DFI的影响,而囊胚形成率降低与高DFI显著相关。Objective:To investigate the effect of sperm DNA damage on cleavage pattern and development of embryos.Methods:The clinical data of 432 patients(432 cycles including 224 cycles of fresh embryo transfer)of assisted reproductive treatment in our center from January 2020 to June 2021 were retrospectively analyzed.According to the different fertilization methods,the patients were divided into ICSI group and IVF group,and each group was subdivided into DFI<15%subgroup and DFI≥15%subgroup respectively according to the sperm DNA fragmentation index(DFI).In ICSI cycles,83 cycles in the subgroup with DFI<15%and 105 cycles in the subgroup with DFI≥15%.In IVF cycles,153 cycles in the subgroup with DFI<15%and 91 cycles in the subgroup with the DFI≥15%.The general data,semen parameters,embryonic development and pregnancy outcome were compared among the groups.Results:In ICSI and IVF cycles,there were no significant differences in women’s age,body mass index(BMI),anti-Mullerian hormone(AMH),FSH,LH levels,Gn dosage and days among the DFI subgroups(P>0.05),but the sperm total motility and concentration in DFI<15%subgroup were significantly higher than those in DFI≥15%subgroup(P<0.05).In terms of embryo development,there was no significant difference in the number of oocytes retrieved,MⅡoocytes,2PN fertilization rate,number of Day 3 available embryos,the rates of embryo with normal cleavage pattern and high-quality blastocyst between DFI subgroups in ICSI and IVF cycles(P>0.05),but the blastocyst formation rate in DFI<15%group was significantly higher than that in DFI≥15%group(69.57%vs.61.09%in ICSI cycle;65.58%vs.57.28%in IVF cycle;P<0.05).In terms of fresh embryo transfer outcome,there were no significant differences in the average number of embryos transferred,the average number of high-quality embryos transferred and the number of embryos with normal cleavage pattern between DFI subgroups in ICSI and IVF cycles(P>0.05),and there were no significant differences in clinical pregnancy rate,implantation rate and abo

关 键 词：精子DNA碎片指数 卵裂模式 2PN受精率 囊胚形成率 妊娠结局 

分 类 号：R711.6[医药卫生—妇产科学]