精液分析参数对体外受精-胚胎移植临床结局的影响研究  

Effect of semen analysis parameters on clinical outcome of in vitro fertilization and embryo transfer

作　　者：高宇琳[1] 祝俭平[1] 邱露露 GAO Yulin;ZHU Jianping;QIU Lulu(Department of Reproductive Medicine Center,Dongguan Maternal and Child Health Care Hospital,Dongguan 523000,Guangdong,China)

机构地区：[1]东莞市妇幼保健院生殖医学中心,广东东莞523000

出　　处：《中国性科学》2022年第4期10-14,共5页Chinese Journal of Human Sexuality

基　　金：东莞市社会科技发展(一般)项目(202050715007863)。

摘　　要：目的探讨精液分析参数对体外受精-胚胎移植(IVF-ET)临床结局的影响。方法回顾性分析2018年1月至2021年7月在东莞市妇幼保健院就诊的377例男性不育患者及其配偶的临床资料,患者行精液常规、精子DNA碎片指数(DFI)和(或)精子顶体酶活性检测。将377例患者按年龄分为<30岁组(n=75)、30~39岁组(n=233)和≥40岁组(n=69),分析三组精液常规分析参数的差异;将329例患者按DFI结果分为DFI≤10%组(n=136)、10%<DFI≤20%组(n=136)和DFI>20%组(n=57),将165例患者按顶体酶活性分为正常组(n=110)与异常组(n=55),分别比较各组患者在年龄、精子正常形态率(NSMR)、前向运动精子率(PR)、胚胎早期发育指标(受精率、卵裂率、可利用胚胎率、优质胚胎率)及临床妊娠率方面差异。结果年龄与精液分析参数相关,≥40岁组NSMR、PR与<30岁组和30~39岁组比较,差异具有统计学意义(P<0.05);不同DFI的三组患者在临床妊娠率、胚胎早期发育指标方面,差异无统计学意义(P>0.05);不同精子顶体酶活性的两组患者在临床妊娠率方面,差异无统计学意义(P>0.05),受精率比较,差异具有统计学意义(P<0.05)。结论男性年龄的增长会对精液分析参数产生影响,精液相关参数分析对IVF临床结局具有一定的预测价值。Objective To investigate the effect of semen analysis parameters on the clinical outcome of in vitro fertilization and embryo transfer(IVF-ET). Methods 377 male infertile patients and their spouses treated in Dongguan Maternal and Child Health Care Hospital from January 2018 to July 2021 were analyzed retrospectively. The patients underwent routine semen analysis, sperm DNA fragmentation index(DFI) analysis and/or sperm acrosin activity analysis. They were divided into<30 years old group(n=75),30-39 years old group(n=233) and ≥40 years old group(n=69) according to age. The differences of semen routine analysis parameters among the three groups were analyzed. 329 patients were divided into DFI≤10% group(n=136),10%<DFI≤20% group(n=136) and DFI>20% group(n=57) according to DFI results. 165 patients were divided into normal group(n=110) and abnormal group(n=55) according to acrosin results. The differences in age, normal sperm morphology rate(NSMR),progressive motility sperm rate(PR),early embryonic development indexes(fertilization rate, cleavage rate, available embryo rate and high-quality embryo rate)and clinical pregnancy rate were compared. Results Age was correlated with semen analysis parameters. The rates of NSMR and PR in ≥40 years old group was significantly different from those in <30 years old group and 30-39 years old group(P<0.05). There were no significant differences in clinical pregnancy rate and early embryo development indexes among the three groups with different DFI(P>0.05). There was no significant difference in clinical pregnancy rate between the acrosin groups(P>0.05),and there was significant difference in fertilization rate(P<0.05). Conclusions The increase of male age will affect the semen analysis parameters, and the analysis of semen related parameters has a certain predictive value for the clinical outcome of IVF.

关 键 词：精液分析 体外受精-胚胎移植 精子顶体酶活性 DNA碎片 

分 类 号：R697[医药卫生—泌尿科学]