精子DNA碎片与活性氧的关系研究及对IVF结局的影响

Relationship between sperm DNA damage and reactive oxygen species and its influence on the outcomes of IVF

目的探讨不育男性的精子DNA损伤程度与精液常规分析各项指标及活性氧的关系,以及对常规体外受精-胚胎移植(IVF-ET)结局的影响。方法接受常规IVF受精的夫妇135例,男性患者作为研究对象,按照精子DNA损伤率将患者分为3组:正常组(精子DNA损伤率0%～15%)79例、轻度损伤组(精子DNA损伤率15%～30%)49例、重度损伤组(DNA损伤率>30%)7例。分析精子DNA损伤对精液常规指标(体积、浓度、活动力和形态)的影响,观察三组患者精浆中过氧化氢(H2O2)、过氧化氢酶(CTA)浓度的变化及三组间受精率、卵裂率、优胚率、种植率、临床妊娠率的差异性。结果重度损伤组的精子活力(a+b)明显低于正常组和轻度损伤组(P<0.05),重度损伤组及轻度损伤组的精子畸形率明显高于正常组(P<0.05)。重度损伤组的优胚率明显低于正常组和轻度损伤组(P<0.05),三组间受精率、卵裂率、植入率和临床妊娠率无统计学差异。重度损伤组精浆中的H2O2浓度明显高于正常组和轻度损伤组(P<0.05),而CTA浓度无统计学差异。结论精子DNA损伤与高H2O2水平有关。精子DNA损伤可导致精液的活动力下降,精子畸形率增高,降低优胚率,不利于IVF-ET的结局。

Objective ： To analyze the relationship between sperm DNA damage and parameters of routine semen analysis, reactive oxygen speciest. And to explore the influence of sperm DNA damage on conventional in vitro fertilization therapy outcome. Methods ： One hundred and thirty - five men who underwent in vitro fertilization and embryo transfer for female infertility were enrolled. They were separated in three groups according to the sperm DNA damage levels： group normal, group slight damage, group severe damage. The influence of sperm DNA damage on sperm volume, concentration, motility and morphology were analyzed. The change of the concentrations of hydrogen peroxide and catalase in semen and the fertilization rate, cleavage rate, good quality embryo rate, implantation rate, clinical pregnancy rate were observed, Results ： There were significant differences of motility and normal morphology among the three groups （ P 〈 0. 05 ）. Fertilization rate, cleavage rate, implantation rate, clinical pregnancy rate were all not found significantly different in three groups. There was a significant declination in good quality embryo rate in group severe （ P 〈 0. 05 ）. The concentrations of hydrogen peroxide in group severe were higher than the other two groups significantly （ P 〈 0. 05 ）. Conclusion ： The high concentration of reactive oxygen species could damage the integrity of the sperm DNA, and the sperm DNA damage could affect the outcomes of IVF by increasing the sperm abnormal morphology and by declining the good quality embryo rate.