精子DNA完整性对囊胚形成时间及形态的影响  

Effect of sperm DNA integrity on formation time and morphology of blastocysts

作　　者：高江曼[1] 魏楠[1] 王媛媛[1] 闫丽盈[1,2,3,4] 乔杰[1,2,3,4] 洪锴[1] GAO Jiang-man;WEI Nan;WANG Yuan-yuan;YAN Li-ying;QIAO Jie;HONG Kai(Center for Reproductive Medicine,Department of Obstetrics&Gynecology,Peking University Third Hospital,Beijing 100191;National Clinical Research Center for Obstetrics&Gynecology(Peking University Third Hospital),Beijing 100191;Key Laboratory of Assisted Reproduction(Peking University),Ministry of Education,Beijing 100191;Beijing Key Laboratory of Reproductive Endocrinology&Assisted Reproductive Technology,Beijing 100191)

机构地区：[1]北京大学第三医院妇产科生殖医学中心,北京100191 [2]北京大学第三医院国家妇产疾病临床医学研究中心,北京100191 [3]北京大学第三医院辅助生殖教育部重点实验室(北京大学),北京100191 [4]北京大学第三医院生殖内分泌与辅助生殖技术北京市重点实验室,北京100191

出　　处：《生殖医学杂志》2023年第7期977-983,共7页Journal of Reproductive Medicine

基　　金：首都卫生发展科研专项(首发2022-2-4049)。

摘　　要：目的探讨精子染色质结构分析(SCSA)检测的精子DNA碎片指数(DFI)和DNA高染色性(HDS)对囊胚形成时间及形态分级的影响。方法回顾性分析2016年5月至2022年9月因单基因疾病来北京大学第三医院生殖医学中心接受辅助生殖技术治疗的242例患者临床资料,共有1167枚囊胚。根据囊胚形成时间分为D5囊胚和D6囊胚,再根据囊胚的内细胞团和滋养外胚层细胞形态学,各分为A、B、C三个等级,分别对各组囊胚的临床资料进行比较,分析不同形成时间及形态分级囊胚间的精子DNA完整性的差异;利用Logistic回归分析精子DNA完整性对囊胚形成时间和质量的影响。结果与D5囊胚组相比,D6囊胚组的男方年龄和精子DFI水平显著升高(P<0.05),抗苗勒管激素(AMH)水平、窦卵泡数(AFC)、精子浓度显著降低(P<0.05)。与内细胞团B级囊胚相比,内细胞团C级囊胚组的AMH水平和AFC显著降低(P<0.05),内细胞团A级囊胚组的精子正常形态率显著升高(P<0.05);与滋养外胚层细胞C级囊胚相比,滋养外胚层细胞A级和B级囊胚组的精子DFI显著降低(P<0.05),滋养外胚层细胞A级囊胚组的精子浓度和正常形态率显著升高(P<0.05)。Logistic回归分析结果显示,精子DFI影响囊胚形成时间,显著增加D6囊胚的概率[OR=1.017,95%CI(1.001,1.033),P=0.047];AFC[OR=0.973,95%CI(0.949,0.998),P=0.036]和精子浓度[OR=0.996,95%CI(0.992,1.000),P=0.048]也是囊胚形成时间的独立影响因素;精子DFI影响囊胚质量,增加非优质囊胚的发生[OR=1.017,95%CI(1.004,1.029),P=0.010];精子HDS对囊胚形成时间和囊胚质量均无显著影响(P>0.05)。结论精子DNA碎片升高可能会延迟胚胎发育,影响囊胚质量,而精子HDS对囊胚的发育和形态分级未见显著影响。Objective:To investigate the influence of DNA fragment index(DFI)and high DNA stainability detected by sperm chromatin structure analysis(SCSA)on the formation time and morphological grading of blastocysts on the blastocyst formation time and morphological grading.Methods:A retrospective analysis was conducted with clinical data of 242 patients who received ART treatment due to monogenic disease at the Center for Reproductive Medicine of Peking University Third Hospital from May 2016 to September 2022.A total of 1167 blastocysts were included.According to the formation time,the blastocysts were divided into Day 5 and Day 6 groups.According to the morphological grade of inner cell mass(ICM)and trophectoderm(TE)cells of the blastocysts,each group was divided into three grades:A,B,and C,respectively.Then the clinical data of each group of blastocysts were compared separately.The differences in sperm DNA integrity between blastocysts with different formation time and morphological grading were analyzed.The effect of sperm DNA integrity on the formation time and morphologic quality of blastocysts was analyzed by logistic regression.Results:Compared to that in Day 5 blastocyst group,male age and sperm DFI level were significantly higher(P<0.05),and AMH level,antral follicle count(AFC)and sperm concentration were significantly lower in Day 6 blastocyst group(P<0.05).Compared to that of the blastocysts with ICM grade B,AMH level and AFC in the blastocysts with ICM grade C decreased significantly(P<0.05),and the sperm normal morphology rate in the blastocysts with ICM grade A increased significantly(P<0.05).Compared with that of the blastocysts with TE grade C,sperm DFI in the blastocysts with TE grade A and B was significantly lower(P<0.05),and the sperm concentration and normal morphology rate in the blastocysts with TE grade A were significantly higher(P<0.05).Logistic regression analysis showed that sperm DFI affected blastocyst formation time and significantly increased Day 6 blastocyst formation probability[OR=1.017

关 键 词：男性不育 精子DNA碎片 DNA高染色性 囊胚形成时间 囊胚形态分级 

分 类 号：R711.6[医药卫生—妇产科学]