计算机辅助精液分析精子运动参数在体外受精中的应用

Computer-assisted sperm analysis for assessing sperm mobility parameters in in vitro fertilization

目的探讨计算机辅助精液分析(CASA)相关运动参数与行IVF治疗后正常受精率、卵裂率及优良胚胎率的关系。方法288例患者按受精情况分为正常受精率≥50%组,正常受精率<50%组;根据卵裂情况分为卵裂率≥90%组及卵裂率<90%组;根据优良胚胎形成情况分为优良胚胎形成率≥50%组,优良胚胎形成率<50%组,记录取卵前男方2次精液检查精子运动相关参数的均值,用t检验法确定各组间相关参数的均值是否存在统计学差异,从而判定与试管婴儿正常受精率、卵裂率及优良胚胎形成率相关的精子运动参数。结果正常受精率≥50%组VCL、VAP、ALH值明显高于正常受精率<50%组,差异具有统计学意义(P<0.05);卵裂率≥90%组VCL、VAP值明显高于卵裂率<90%组,差异具有统计学意义(P<0.05);优良胚胎形成率≥50%组与优良胚胎形成率<50%组间VCL、VSL、VAP、LIN、STR、WOB、ALH、BCF均无统计学差异(P>0.05)。结论正常受精率、卵裂率与精子运动能力有关;试管婴儿优良胚胎形成率的大小与精子运动参数无关。

Objective To evaluate the association of sperm mobility parameters assessed by computer-assisted sperm analysis （CASA） with the rates of normal fertilization, oocyte cleavage and excellent embryos in in vitro fertilization （IVF） cycles. Methods A total of 288 infertile women undergoing IVF cycles patients were divided into two groups according to the normal fertilization rate （≥50% and 〈50%）, cleavage rate （≥90% and 〈90%）, or excellent embryo rates （≥50% and 〈50%）. The means of the sperm motility parameters analyzed by CASA twice before oocyte retrieval were recorded and analyzed using t-test in relation to the rates of normal fertilization, cleavage and excellent embryos in IVF cycles. Results The mean curvilinear velocity （VCL）, average path velocity （VAP）, and amplitude of lateral head displacement （ALH） were significantly higher in women with a normal fertilization rate of ≥50% than in those with a normal fertilization rate of 〈50% （P〈0.05）. Women with an oocyte cleavage rate of≥ I〉90% had significantly higher VCL and VAP than those with a cleavage rate of 〈90% （P〈0.05）. The VCL, straight line velocity （VSL）, VAP, linearity, straightness, wobble coefficient, ALH, or beat-cross frequency showed no significant differences between women with excellent embryo rates of ≥50% and 〈50% （P〉0.05）. Conclusion The sperm motility parameters assessed using CASA are associated with normal fertilization and oocyte cleavage rates but not with excellent embryo rate in IVF cycles.