精子核DNA完整性测定方案的优化及其在辅助生殖技术中的应用价值  

Optimization of Sperm Nuclear DNA Integrity Assay and Its Application in Assisted Reproductive Technology

作　　者：刘居理 陈胜辉 杨丽娟[1] 杨韦华 饶研文 章梦颖 张端军 LIU Juli;CHEN Shenghui;YANG Lijuan(Department of Reproductive Medicine,Affiliated Reproductive Hospital of Jiangxi University of Traditional Chinese Medicine,Reproductive Hospital of Nanchang,Nanchang Jiangxi 330004,China)

机构地区：[1]江西中医药大学附属生殖医院南昌市生殖医院生殖医学科,江西南昌330004

出　　处：《实用妇产科杂志》2024年第2期136-140,共5页Journal of Practical Obstetrics and Gynecology

基　　金：江西省卫生健康委科技计划项目(编号:202140191)。

摘　　要：目的:对现有精子核DNA完整性测定方案进行优化,并探讨其在辅助生殖技术(ART)中的应用价值。方法:选择2021年1月1日至2022年12月8日于江西中医药大学附属生殖医院就诊的拟接受体外受精-胚胎移植(IVF-ET)助孕的194对夫妇作为研究对象。采集男方的精液作为对照组(n=194),同一精液经双层密度梯度离心法优化处理后精子混合液作为观察组(n=194)。根据精子核DNA碎片率(DFI)测定结果将对照组及观察组各分为3个亚组,对照A组和观察A组:DFI<15%,对照B组和观察B组:DFI 15%~30%,对照C组和观察C组:DFI≥30%。对观察组与对照组的DFI值及各亚组间的助孕及妊娠情况进行比较。结果:(1)观察组DFI明显低于对照组,差异有统计学意义[(13.55±10.17)%vs.(18.56±11.54)%,P<0.05]。(2)6个亚组间的受精率、卵裂率及优胚率两两比较,差异无统计学意义(P>0.05)。(3)6个亚组的妊娠率和着床率比较,差异有统计学意义(P<0.05);其中,对照A组、对照B组、观察A组、观察B组4组的临床妊娠率(均在65.00%以上)及着床率(均在50.00%)两两比较,差异均无统计学意义(P>0.05),但均高于对照C组(43.24%、31.67%)及观察C组(13.64%、8.82%),差异有统计学意义(P<0.05);对照C组的临床妊娠率及着床率明显高于观察C组,差异有统计学意义(P<0.05)。结论:精液经优化处理后精子核DNA完整性可明显改善。两种不同检测方案在ART中均有较好的应用价值,当精液经优化处理后DFI≥30%时,对ART的不良妊娠结局具有更好的预测价值。Objective:To optimize the existing protocols for the detection of sperm nuclear DNA integrity and to explore their application value in assisted reproductive technology.Methods:194 couples intending to undergo in vitro fertilization-embryo transfer(IVF-ET)treatment at the Affiliated Reproductive Hospital of Jiangxi University of Traditional Chinese Medicine from January 1,2021,to December 8,2022,were selected as the study subjects.The sperm samples from the male partners were collected as the control group,and the same semen,processed after optimization using a double-layer density gradient centrifugation method,was used as the observation group.According to the DNA fragmentation index(DFI)results,the control group and the observation group were divided into three subgroups,control group A and observation group A:DFI<15%;control group B and observation group B:DFI 15%~30%;control group C and observation group C:DFI≥30%.Then the DFI values of the observation group and control group were compared.The conditions of assisted pregnancy and pregnancy were analyzed among the subgroups.Results:①The sperm DNA fragmentation index(DFI)of the observation group was significantly lower than that of the control group[(13.55±10.17)%vs.(18.56±11.54)%,P<0.05].②There was no significant difference in fertilization rate,cleavage rate and high-quality embryo rate among the six subgroups(P>0.05).③There were significant differences in pregnancy rate and implantation rate among the six subgroups(P<0.05);The clinical pregnancy rate(all above 65.00%)and implantation rate(all above 50.00%)were compared among four groups:control group A,control group B,observation group A and observation group B.There was no significant difference among the four groups(P>0.05),but they were all higher than those of control group C(43.24%,31.67%)and observation group C(13.64%,8.82%)(P<0.05).The clinical pregnancy rate and implantation rate in the control group were significantly higher than those in the observation group C(P<0.05).Conclusions:The DN

关 键 词：精子核DNA完整性 辅助生殖技术 精子核DNA碎片率 胚胎质量 妊娠结局 

分 类 号：R711.6[医药卫生—妇产科学] R446.19[医药卫生—临床医学]