精子顶体反应检测在辅助生殖中应用价值回顾性研究  

A retrospective study on the application value of acrosome reaction detection in assisted reproduction

作　　者：万凌 杨继高 张天枫 刘晓淋 马婧 WAN Ling;YANG Jigao;ZHANG Tianfeng;LIU Xiaolin;MA Jing(Center for Reproductive Medicine,Chongqing Health Center for Women and Children(Women and Children’s Hospital of Chongqing Medical University),Chongqing 400013,China;Chongqing Human SpermBank,Chongqing Population and Family Planning Science and Technology Research Institute,Chongqing 401120,China;NHC Key Laboratory of Birth Defects and Reproductive Health,Chongqing,401120,China)

机构地区：[1]重庆市妇幼保健院(重庆医科大学附属妇女儿童医院)生殖医学中心,重庆400013 [2]重庆市人口和计划生育科学技术研究院人类精子库,重庆401120 [3]国家卫生健康委出生缺陷与生殖健康重点实验室,重庆401120

出　　处：《中国优生与遗传杂志》2024年第12期2570-2575,共6页Chinese Journal of Birth Health & Heredity

基　　金：重庆市科卫联合医学科研项目(2022MSXM087)。

摘　　要：目的探讨流式法检测Ca^(2+)诱发精子顶体反应(IAR)在辅助生殖中应用价值。方法回顾分析2019年6月至2021年5月在重庆市妇幼保健院生殖医学中心就诊的262对夫妇的临床数据,其中体外受精(IVF)135例,卵细胞质内单精子注射(ICSI)127例。依据卵子受精率及其正常受精率大于等于或低于30%,以及妊娠结局分组,分别统计分析IVF与ICSI助孕各组间临床资料、精液参数、IAR结果。采用受试者操作特征(ROC)曲线与回归分析分别确定预测卵子发生低正常受精的IAR截断值和独立因素。结果IVF助孕时,卵子受精率及正常受精率高(≥30%)组中IAR值均显著高于<30%组(P<0.05);妊娠组与未妊娠组精液参数、IAR值差异无统计学意义(P>0.05)。22.80%为预测IVF助孕时卵子发生低正常受精(<30%)的IAR截断值,并为其独立因素。ICSI助孕时,卵子受精率高(≥30%)组与低(<30%)组比较,精子浓度差异显著(P<0.05);正常受精率高低两组间,妊娠及未妊娠组间精液参数、IAR值均无统计学差异(P>0.05)。当IAR>22.80%时,IVF助孕发生卵子低正常受精率(<30%)的比例显著降低(P<0.05),而ICSI助孕时无差异。结论本研究发现IAR结果可预测IVF助孕时卵子低正常受精(<30%)情况发生,但不能预测其妊娠结局。ICSI助孕时IAR值与卵子受精率,卵子正常受精率及妊娠结局均无显著相关性。流式法检测IAR在辅助生殖中有一定应用价值。Objective To explore the application value of detecting Ca^(2+)induced acrosome reaction(IAR)through flow cytometry in assisted reproductive technology(ART).Methods A retrospective analysis of clinical data from 262 couples,who visited the Center for Reproductive Medicine of Chongqing Health Center for Women and Children from June 2019 to May 2021,including 135 cases of in vitro fertilization(IVF)and 127 cases of intracytoplasmic sperm injection(ICSI).The couples were grouped based on whether the fertilization rate and the normal fertilization rate were greater than or equal to 30%,along with pregnancy outcomes.The clinical data,conventional semen parameters,and IAR results were statistically analyzed between the IVF and ICSI groups.Receiver operating characteristic(ROC)curve were used to determine IAR cutoff values,and regression analysis were used to predict independent predictors of low normal fertilization of ovum.Results During IVF assisted pregnancy,the IAR in the oocyte fertilization rate and normal fertilization rate(≥30%)group were significantly higher than those in the<30%group(P<0.05).No significant differences in semen parameters and IAR were observed between the pregnant and non-pregnant groups(P>0.05).The IAR cutoff value predicting low normal fertilization(<30%)in IVF assisted pregnancy was found to be 22.80%,which was an independent factor.In the ICSI assisted pregnancy,there was a significant difference in sperm concentration between the high(≥30%)and low(<30%)oocyte fertilization rate groups(P<0.05).No significant differences in semen parameters or IAR were found between the pregnant and non-pregnant groups for both normal and low fertilization rates(P>0.05).When IAR was more than 22.80%,the proportion of low normal fertilization rate(<30%)in IVF significantly decreased(P<0.05),while no difference was observed in ICSI assisted pregnancy.Conclusion This study showed that IAR results can predict the low normal fertilization(<30%)in oocytes in IVF but cannot predict pregnancy outcomes.In ICSI a

关 键 词：顶体反应 体外受精 卵细胞内单精子注射 

分 类 号：R71[医药卫生—妇产科学]