精子DNA碎片指数与IVF/ICSI结局的相关性研究  

Correlation between sperm DNA fragmentation index and outcomes of IVF/ICSI

作　　者：舒慧泉 吴正沐[1,2] 薛竞东 杨俊 王正权 王旻 冯超[1,2] Shu Huiquan;Wu Zhengmu;Xue Jingdong;Yang Jun;Wang Zhengquan;Wang Min;Feng Chao(Department of Reproductive Medicine,The International Peace Maternity and Child Health Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200030,China;Shanghai Key Laboratory of Embryo Original Diseases,Shanghai 200030,China;Department of Urology,Tongji Hospital of Tongji University,Shanghai 200065,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生殖中心,上海200030 [2]上海市胚胎源性疾病重点实验室,上海200030 [3]同济大学附属同济医院泌尿外科,上海200065

出　　处：《中国男科学杂志》2024年第4期60-64,共5页Chinese Journal of Andrology

基　　金：国家自然科学基金面上项目(82070694)。

摘　　要：目的探讨精子DNA碎片指数(DFI)与IVF/ICSI助孕结局的关系。方法回顾性分析2021年1月1日至2021年12月31日在我院首次接受IVF或ICSI方案助孕,男方接受精子DFI检测,且符合纳入标准的378对夫妻的临床资料。将男方年龄、精子浓度、前向运动精子百分率、正常形态精子百分率分别与精子DFI进行Spearman秩相关分析。将男方年龄、女方年龄、精子浓度、前向运动精子百分率、正常形态精子百分率、精子DFI纳入二分类多因素非条件Logistic回归分析,分析IVF/ICSI助孕结局影响因素。探究女性配偶流产及早产发生率与精子DFI的相关性。结果精子DFI与前向运动精子百分率呈负相关(r=-0.627,P<0.001),与正常形态精子百分率亦呈负相关(r=-0.349,P<0.001)。精子DFI是阻碍IVF组获得累积活产的影响因素(OR=0.855,P<0.001)。精子DFI与ICSI助孕是否获得累积活产无关(P=0.127)。进一步分析还可见,精子DFI与IVF/ICSI助孕后发生流产/早产无明显相关性(P值分别为0.521、0.824)。结论精子DFI的升高是IVF助孕的不利影响因素,应重视精子DFI的检测。Objective To investigate the relationship between sperm DNA fragmentation index(DFI)and outcomes of in vitro fertilization(IVF)/intracytoplasmic sperm injection,ICSI.Methods The clinical data of 378 couples underwent IVF/ICSI treatment first time in our hospital from January 1st 2021 to December 31st 2021 were retrospectively analyzed.The husbands had underwent sperm DFI test and all the couples met the inclusion criteria.Spearman rank correlation analysis was conducted between the male age,sperm concentration,progressive motility(%),and normal forms(%)and sperm DFI,respectively.The male age,female age,sperm concentration,progressive motility(%),normal forms(%)and sperm DFI were included in binary multivariate unconditional logistic regression analysis to determine influence factors for outcomes of IVF/ICSI.Mann-Whitney U test was conducted to analyze the relationship between the incidence of premature and abortion and sperm DFI.Results Sperm DFI was negatively correlated with progressive motility(%)(r=-0.627,P<0.001)and normal forms(%)(r=-0.349,P<0.001).Sperm DFI was an adverse factor for successful delivery in IVF group(OR=0.855,P<0.001).The impact of sperm DFI on ICSI outcomes was not statistically significant(P=0.127).There was no correlation between abortion and premature/sperm DFI in vitro fertilization.Conclusion Sperm DFI is an adverse factor for successful delivery in IVF.Sperm DFI test deserves more attention.

关 键 词：精子 DNA碎片 体外受精 妊娠结局 

分 类 号：R698.2[医药卫生—泌尿科学] R321.1[医药卫生—外科学]