精子相关参数与体外受精受精率的相关性研究  

Orrelations of sperm parameters with fertilization rate of in vitro fertilization

作　　者：黄玲 杨帆[1] 江利[1] 李苏萍[1] HUANG Ling;YANG Fan;JIANG Li;LI Suping(Center for Reproductive Medicine,Chenzhou First People's Hospital,Chenzhou 423000,Hunan,China)

机构地区：[1]郴州市第一人民医院生殖医学中心,湖南郴州423000

出　　处：《临床检验杂志》2024年第2期111-116,共6页Chinese Journal of Clinical Laboratory Science

基　　金：郴州市科技发展计划项目(ZDYF2020124)。

摘　　要：目的探讨精子参数与体外受精(IVF)受精率的相关性。方法回顾性分析2020年4月至2023年4月在郴州市第一人民医院生殖医学中心进行IVF助孕的符合纳入、排除标准的327例病例。依据我中心胚胎实验室质控数据考核标准分为低受精组(受精率<30%,n=19)和正常受精组(受精率≥30%,n=308)。收集男方的基本信息与精子相关参数以及胚胎信息。用Pearson相关性分析各参数与精子受精率的相关性,Logistic回归分析精子受精率的影响因素,采用ROC曲线分析预测价值。结果精子顶体酶活性、正常形态精子百分率、精子DNA碎片指数(DFI)是影响受精率的相关因素,相关系数(r)分别为0.168、0.306、-0.243(P均<0.05)。Logistic回归分析确定三者均是影响IVF受精率的独立因素,并得出多因素回归方程式:受精率预估值=-2.561+0.035×精子顶体酶活性+2.066×正常形态精子百分率-1.51×精子DFI。精子顶体酶活性、正常形态精子百分率、精子DFI及三因素联合预测低受精率的ROC曲线下面积(AUC^(ROC))分别为0.806、0.889、0.827、0.899,其Yuden指数对应的cut-off值分别为61.2μIU/10^(6)精子、2.98%、27.50%、-21.32,敏感性分别为95.70%、76.90%、68.40%、64.30%,特异性分别为43.50%、94.70%、87.70%、100.00%,表明3个指标联合预测受精率的效能较好。结论精子顶体酶活性、正常形态精子百分率、精子DFI是预测IVF受精率的独立影响因素;可以用多因素回归方程式预测IVF的受精率。Objective To investigate the correction between the fertilization rate of in vitro fertilization(IVF)and sperm parameters.Methods This retrospective study included 327 cases undergoing IVF procedures in the Center for Reproductive Medicine of Chenzhou First People's Hospital,who were divided into a low fertilization group(fertilization rate<30%,n=19)and normal fertilization group(fertilization rate≥30%,n=308)based on the assessment standards of quality control data in the embryology laboratory of our center.The basic information of males,embryo information and related sperm parameters were collected,and the correction between sperm parameters and the fertilization rate was analyzed by Pearson correlation.The influencing factors of the fertilization rate were ana-lyzed by binary logistic regression,and the area under the receiver operating characteristic(ROC)curve(AUC)was performed to analyze the predictive value of low fertilization rate.Results The sperm acrosin activity,percentage of spermatozoa with noral morphology and sperm DNA fragmentation index(DFI)were the relevant factors affecting the fertilization rate,and the correlation coefficients were 0.168,0.306,and-0.243,respectively(all the P<0.05).Logistic regression analysis showed that all the three indicators were independent factors affecting the fertilization rate of IVF,and the multivariate logistic equation was as follows:estimated fertilization rate=-2.561+0.035 Xacrosin activity+2.066X percentage of sperm with normal morphology-1.51 Xsperm DFI.The areas under the ROC curve(AUC)of acrosin activity,percentage of sperm with normal morphology,sperm DFI and the combination of them were 0.806,0.889,0.827 and 0.899,respectively.The corresponding cut-off values for the Yuden index were 61.20μIU/10^(6)sperm,2.98%,27.50%and-21.32,respectively.The sensitivity of acrosin activity,percentage of sperm with normal morphology,sperm DFI and the combination of three indicators for the prediction of low fertilization rate were 95.70%,76.90%,68.40%,64.30%,and their.s

关 键 词：精子顶体酶活性 正常形态精子百分率 精子DNA碎片指数 体外受精 正常受精率 

分 类 号：R446[医药卫生—诊断学] R321[医药卫生—临床医学]