精子线粒体膜电位与精液参数和IVF妊娠结局的相关性分析  

Correlation of sperm mitochondrial membrane potential with semen parameters and outcomes of in vitro fertilization

作　　者：戎春浩[1] 李洁[1] 史海跃[1] 蔡婕[1] 周黎明[1] RONG Chun-hao;LI Jie;SHI Hai-yue;CAI Jie;ZHOU Li-ming(Center of Reproduction,Ningbo Women and Children Hospital,Ningbo,Zhejiang 315013,China)

机构地区：[1]宁波市妇女儿童医院生殖中心,浙江宁波315013

出　　处：《中华男科学杂志》2022年第7期612-617,共6页National Journal of Andrology

基　　金：浙江省医药卫生科技计划(2019RC268);宁波市医疗卫生品牌学科(PPXK2018-06)。

摘　　要：目的:探讨精子线粒体膜电位(MMP)与常规精液参数的相关性,以及MMP对体外受精(IVF)妊娠结局的影响。方法:回顾性分析宁波市妇女儿童医院生殖中心2018年11月至2019年10月727个IVF周期的临床资料(其中新鲜移植周期231个),用JC-1染色及流式细胞仪检测MMP,根据MMP水平分为低MMP组(≤52%)与高MMP组(>52%),比较两组的受精率、临床妊娠率、流产率、活产率。同时结合常规精液参数,分析精子MMP与精液量、精子浓度、精子总数、精子活动率、前向运动精子百分率、正常形态精子百分率、精子DNA碎片指数之间的关系。结果:高MMP组受精率[85.3%(2211/2592)]显著高于低MMP组[81.7%(3910/4785)],P<0.01;高MMP组临床妊娠率、活产率[50.00%(41/82)、43.90%(36/82)]显著高于低MMP组[48.32%(72/149)、40.94%(61/149),P均<0.05];而流产率[12.20%(5/41)]低于低MMP组[15.28%(11/72)],但差异均无统计学意义(P>0.05)。两组精子浓度、精子活动率、前向运动精子百分率、正常形态精子百分率、精子DNA碎片指数差异均存在统计学意义(P均<0.05),而精液量、精子总数差异无统计学意义(P>0.05);精子MMP与精子浓度(r=0.11,P<0.05)、精子活动率(r=0.304,P<0.01)、前向运动精子百分率(r=288,P<0.01)、正常形态精子百分率(r=458,P<0.01)呈显著正相关,与精子DNA碎片指数(r=0.387,P<0.01)呈显著负相关。结论:精子运动能力下降、精子畸形率增加、DNA碎片指数上升、IVF受精率降低与精子MMP水平有关,是重要的精子功能评估指标,有助于联合常规精液参数,综合评估并优化不育男性在辅助生殖技术治疗中的助孕方案。Objective:To investigate the correlation of sperm mitochondrial membrane potential(MMP)with routine semen parameters and the effect of MMP on the outcomes of in vitro fertilization(IVF).Methods:We retrospectively analyzed the clinical data on 727 IVF cycles,including 231 fresh transplantation cycles,in our hospital from November 2018 to October 2019.According to the MMP level determined by JC-1 staining and flow cytometry,we divided the patients into a low MMP(≤52%)and a high MMP(>52%)group and compared the rates of fertilization,clinical pregnancy,abortion and live birth between the two groups.Meanwhile,we analyzed the correlation of sperm MMP with the semen volume,sperm concentration,total sperm count,total sperm motility,percentages of progressively motile sperm(PMS)and morphologically normal sperm(MNS),and sperm DNA fragmentation index(DFI).Results:The fertilization rate was significantly higher in the high MMP than in the low MMP group(85.3%[2211/2592]vs 81.7%[3910/4785],P<0.01),and so were the rates of clinical pregnancy(50.00%[41/82]vs 48.32%[72/149],P<0.05)and live birth(43.90%[36/82]vs 40.94%[61/149],P<0.05),while the abortion rate was lower in the former than in the latter group(12.20%[5/41]vs 15.28%[11/72],P>0.05).Statistically significant differences were observed between the two groups in sperm concentration,total sperm motility,percentages of PMS and MNS,and sperm DFI(P<0.05),but not in the semen volume and total sperm count(P>0.05).Sperm MMP was found correlated positively with sperm concentration(r=0.11,P<0.05),total sperm motility(r=0.304,P<0.01)and percentages of PMS(r=288,P<0.01)and MNS(r=458,P<0.01)but negatively with sperm DFI(r=0.387,P<0.01).Conclusion:The level of sperm MMP is related to decreased sperm motility,increased sperm abnormality,elevated sperm DFI and reduced IVF rate.It is also an important index for sperm function evaluation and,together with routine semen parameters,helps to comprehensively evaluate and optimize the assisted pregnancy program of infertile men in assisted rep

关 键 词：男性不育 精子质量 精子线粒体膜电位 体外受精 受精率 临床妊娠结局 

分 类 号：R321.1[医药卫生—人体解剖和组织胚胎学]