精子DNA碎片率及精子存活率联合检测对体外受精-胚胎移植助孕结局的预测价值分析  

Predictive value of combined detection of sperm DNA fragment rate and sperm viability rate for assisted pregnancy outcome of IVF-ET

作　　者：王金宝 张玉强 韩越 刘俊英 马国燕 WANG Jin-bao;ZHANG Yu-qiang;HAN Yue;LIU Jun-ying;MA Guo-yan(Department of Reproductive Medicine,Xingtai Third Hospital,Xingtai054000)

机构地区：[1]邢台市第三医院生殖医学科,邢台054000

出　　处：《生殖医学杂志》2023年第5期671-676,共6页Journal of Reproductive Medicine

基　　金：邢台市重点研发计划自筹项目(2021ZC095)。

摘　　要：目的 分析精子DNA碎片率(DFI)联合精子存活率检测,对不育症患者辅助生殖技术助孕结局的预测价值。方法 选择2020年2月至2022年1月在本院行体外受精-胚胎移植治疗的168例不育症患者为研究对象,根据男方不同DFI值将患者分为低DFI组(DFI≤25%的患者,n=108)和高DFI组(DFI>25%的患者,n=60);又根据精子存活率将患者分为高存活率组(精子存活率≥85%的患者,n=121)和低存活率组(精子存活率<85%的患者,n=47),比较各组间一般资料及助孕结局;采用受试者工作特征曲线(ROC)分析DFI及精子存活率对临床妊娠的预测价值。结果 与低DFI组比较,高DFI组前向运动精子、HCG阳性率、临床妊娠率显著降低(P<0.05);与高存活率组比较,低存活率组前向运动精子、HCG阳性率、临床妊娠率显著降低(P<0.05)。Spearman法分析结果显示,DFI与精子存活率呈负相关(r=-0.587,P<0.05),与前向运动精子、HCG阳性率、临床妊娠率呈负相关(r分别为-0.507、-0.514、-0.489,P<0.05);精子存活率与前向运动精子、HCG阳性率、临床妊娠率呈正相关(r分别为0.496、0.503、0.512,P<0.05)。ROC分析结果显示,精子DFI对临床妊娠的预测ROC曲线下面积(AUC)为0.84,敏感度为80.36%,特异性为76.54%;精子存活率的预测AUC为0.89,敏感度为84.82%,特异性为75.58%;精子DFI联合精子存活率检测的预测AUC为0.94,敏感度为83.34%,特异性为87.22%。结论 高精子DFI与低精子存活率不利于不育症夫妻辅助生殖助孕结局,精子DFI联合精子存活率检测对于预测助孕治疗妊娠结局的价值较高。Objective:To analyze the predictive value of combined detection of sperm DNA fragmentation index(DFI)and sperm viability rate on the pregnancy outcomes of assisted reproductive technology in infertile couples.Methods:A total of 168 male infertile patients who underwent IVF-ET assisted pregnancy in our hospital from February 2020 to January 2022 were selected as subjects in this study.The patients were divided into low DFI group(DFI≤25%,n=108)and high DFI group(DFI>25%,n=60)according to the different DFI.Then,the patients were divided into high sperm viability rate group(≥85%,n=121)and low sperm viability rate group(<85%,n=47)according to sperm viability rate.The general data and pregnancy outcome were compared among the groups.The predictive value of DFI and sperm viability rate for clinical pregnancy rate was analyzed by receiver operating characteristic curve(ROC).Results:Compared with the low DFI group,the high DFI group had significantly lower forward motile sperm rate,HCG positive rate and clinical pregnancy rate(P<0.05).Compared with the high sperm viability rate group,the low sperm viability rate group had significantly lower forward motile sperm rate,HCG positive rate and clinical pregnancy rate(P<0.05).The analysis results of Spearman method show that DFI was negatively correlated with sperm viability rate(r=-0.587,P<0.05),and DFI was negatively correlated with forward motile sperm rate(r=-0.507),HCG positive rate(r=-0.514)and clinical pregnancy rate(r=-0.489)(P<0.05).Sperm viability rate was positively correlated with forward motile sperm rate(r=0.496),HCG positive rate(r=0.503)and clinical pregnancy rate(r=0.512)(P<0.05).ROC analysis results show that the predictive area under the ROC curve(AUC)of sperm DFI for clinical pregnancy was 0.84 with sensitivity of 80.36%and specificity of 76.54%.The predicted AUC of sperm viability rate for clinical pregnancy was 0.89 with sensitivity of 84.82%and specificity of 75.58%.The predictive AUC of combined detection of sperm DFI and sperm viability rate for cli

关 键 词：精子DNA碎片率 精子存活率 辅助生殖技术 妊娠结局 

分 类 号：R698.2[医药卫生—泌尿科学]