摘要
目的:探讨男性不育患者精子染色体畸变率及其对ICSI结果的影响。方法:随机选取外周血细胞染色体正常、行ICSI治疗的男性不育患者32例,其中少精症8例、严重少精症9例、阻塞性无精症经皮附睾穿刺吸精子11例、精液正常但常规IVF不受精患者4例以及5例对照组。应用荧光原位杂交技术检测了各类男性不育患者精子性染色体、13、18、21号染色体非整倍体的发生率和二倍体的发生率,统计分析这些染色体畸变的发生率与ICSI后的受精率、卵裂率、优质胚胎率、妊娠率、胚胎种植率以及流产率之间的关系。结果:少精症组精子性染色体非整倍体发生率明显升高(0.58%、0.25%,P<0.001),常见的形式为精子XY二体、XX二体以及YY二体;在严重少精症组,精子性染色体二体率(0.94%、0.25%)、13号染色体二体率(0.40%、0.09%)、21号染色体二体率(0.48%、0.10%)、二倍体率(0.43%、0.09%)明显高于对照组,有显著性差异(P<0.001);在阻塞性无精症组,性染色体二体率(1.43%、0.25%)、二倍体率(0.32%、0.09%)明显高于对照组,有显著性差异(P<0.001)。在IVF不受精组,各项检测指标与对照组相比无明显差异。严重少精症组ICSI后的优质胚胎率、妊娠率以及胚胎种植率明显下降,流产率升高。结论:在行ICSI治疗前,用FISH方法进行精子染色体畸变的检测是有效的,也是必要的;对检测阳性的患者,在行ICSI后对早期胚胎进行遗传学检测可减少或避免遗传缺陷的发生。
Objective: To analyze incidence of sperm chromosomal abnormalities among infertile men and relationship with the abnormalities and ICSI outcome. Methods: 32 infertile men with normal chromosomes who received a treatment by ICSI and 5 normal fertile men as a control group were selected randomly. Of them, there were 8 men with oligospermia, 9 severe oligozoospermia, 11 obstructive azoospermia and 5 failure insemination after IVF. Frequency of chromosome 13, 18, 21 disomy and aneuploidy in infertile patients was investigated by fluorescence in - situ hybridization (FISH). Relationship among incidence of chromosomal abnormalities, fertilization rate, cleavage rate, excellent embryo rate, embryo transfer rate and abortion rate was studied. Results: Frequency of sex chromosome aneuploidy was clearly increasing in oligospermic men (0. 58%, 0. 25% ,P 〈0. 001 ) and general expressions were disomy XY, XX and YY. Disomy frequency of sex chromosome ( 0. 94%, 0. 25% ) , chromosome 13 ( 0. 40%, 0. 09% ) , chromosome 21 ( 0. 48%, 0. 10% )and rates of dipoidy in severe oligozoospermic men (0. 43% ,0. 09% ) were higher than that in con- trol group ( P 〈 O. 001 ). Disomy frequency of sex chromosome ( 1.43%, O. 25% ) and rates of dipoidy (0. 32% ,0. 09% ) in obstructive azoospermic men were higher that in control group ( P 〈0. 001 ). Indexes in 5 cases of failure insemination after IVF were not different from ones in control group. There was lower fer- tilization rate, less excellent embryos, lower embryo transfer rate and increasing abortion rate after a treatment of ICSI in obstructive azoospermic men. Conclusion: It is useful and necessary to screen chromosomal abnormalities by fluorescence in - situ hybridization (FISH) before a treatment of ICSI.
出处
《中国计划生育学杂志》
北大核心
2005年第10期604-609,共6页
Chinese Journal of Family Planning