时差成像胚胎培养系统观察精子DNA碎片化指数对卵胞浆内单精子显微注射的胚胎发育及临床结局的影响  

Observation of the impact of sperm DNA fragmentation index on embryonic development and clinical outcomes of intracytoplasmic sperm injection using time-lapse imagining embryo culture system

作　　者：吴正沐[1] 王正权 王旻[1] 谈雅静[1] 李文[1] Wu Zhengmu;Wang Zhengquan;Wang Min;Tan Yajing;Li Wen(Department of Assisted Reproduction,the International Peace Maternity and Child Health Hospital,School of Medicine,Shanghai Jiao Tong University,Shanghai 200030,China)

机构地区：[1]上海交通大学医学院附属国际和平妇幼保健院辅助生殖科,上海200030

出　　处：《发育医学电子杂志》2024年第2期130-135,共6页Journal of Developmental Medicine (Electronic Version)

基　　金：上海交通大学“交大之星”计划“医工交叉研究基金”重点项目(YG2023ZD27)。

摘　　要：目的使用时差成像(time-lapse imagining,TLI)胚胎培养系统观察精子DNA碎片化指数(DNA fragmentation index,DFI)对卵胞浆内单精子显微注射(intracytoplasmic sperm injection,ICSI)的胚胎发育指标及临床结局的影响。方法选取2023年1月至6月在上海交通大学医学院附属国际和平妇幼保健院辅助生殖科接受ICSI技术助孕的392对夫妇为研究对象,分为常规培养组284周期和TLI组108周期,再根据DFI≤15%、>15%~<30%、≥30%进一步分为正常组、临界组、异常组。比较各组的临床资料以及临床妊娠结局。统计学方法采用t检验、单因素方差分析、χ^(2)检验或Fisher确切概率法。结果6组的女方年龄、基础促卵泡激素(follicle stimulating hormone,FSH)、身体质量指数(body mass index,BMI)及获卵数比较,差异均无统计学意义(P值均>0.05);男方精液常规指标中,浓度和正常形态率比较,差异均无统计学意义(P值均>0.05);常规正常组、常规临界组、常规异常组、TLI正常组、TLI临界组和TLI异常组的前向运动精子率分别为(46.5±16.5)%、(31.0±14.2)%、(14.8±8.4)%、(41.6±16.2)%、(32.5±14.4)%、(19.3±11.1)%,常规异常组和TLI异常组的前向运动精子率分别低于常规正常组、常规临界组、TLI正常组和TLI临界组(P值均<0.05)。6组的卵裂率和囊胚形成率比较,差异无统计学意义(P>0.05)。常规正常组、常规临界组、常规异常组、TLI正常组、TIL临界组和TLI异常组的受精率分别为(77.3±18.6)%、(78.6±17.1)%、(68.3±22.7)%、(77.4±14.5)%、(74.5±13.1)%、(63.1±25.4)%;常规异常组的受精率低于常规正常组、常规临界组、TLI正常组(P值均<0.05);TLI异常组的受精率低于常规正常组、常规临界组、TLI正常组、TLI临界组(P值均<0.05)。常规正常组、常规临界组、常规异常组的妊娠率分别为57.4%(39/68)、54.5%(24/44)、27.3%(6/22),异常组低于正常组和临界组(P值均<0.05)。TLI正常组、TLI临界组和TLI�Objective To observe the impact of sperm DNA fragmentation index(DFI)on embryonic development and clinical outcomes of intracytoplasmic sperm injection(ICSI)using time-lapse imagining(TLI)embryo culture system.Method A total of 392 couples who received ICSI assisted pregnancy in the Department of Assisted Reproduction,the International Peace Maternal and Child Health Hospital,School of Medicine,Shanghai Jiao Tong University from January to June 2023 were selected as the study subjects.They were divided into 284 cycles in the conventional culture group and 108 cycles in the TLI group.According to DFI≤15%,>15%~<30%,≥30%,further divided into normal group,critical group,abnormal group.The clinical data and clinical pregnancy outcomes of all groups were compared.Statistical methods performed by t-test,one-way analysis of variance andχ^(2) test or Fisher exact probability method.Result There were no significant differences in female age,follicle stimulating hormone(FSH),body mass index(BMI)and number of eggs harvested in the 6 groups(all P>0.05).There was no significant difference between the concentration and normal form rate of male semen(all P>0.05).The forward motility sperm rates of normal group,critical group,abnormal group in conventional group,normal group,critical group and abnormal group in TLI group were(46.5±16.5)%,(31.0±14.2)%,(14.8±8.4)%,(41.6±16.2)%,(32.5±14.4)%and(19.3±11.1)%,respectively.The forward motility sperm rate in conventional normal group and TLI abnormal group was lower than that in normal group,critical group,normal group and critical group in TLI group,respectively(all P<0.05).There was no significant difference in cleavage rate and blastocyst formation rate among the 6 groups(P>0.05).The fertilization rates of normal group,critical group,abnormal group in conventional group,normal group,critical group and abnormal group in TLI group were(77.3±18.6)%,(78.6±17.1)%,(68.3±22.7)%,(77.4±14.5)%,(74.5±13.1)%and(63.1±25.4)%,respectively.The fertilization rate of the conventional no

关 键 词：精子DNA碎片化指数 受精率 优质胚胎率 时差成像 妊娠结局 卵胞浆内单精子显微注射 

分 类 号：R714.8[医药卫生—妇产科学]