精子DNA碎片对IVF-ET结局的影响

Effects of sperm DNA fragmentation on outcomes of IVF-ET

目的:探讨精子DNA碎片化率(DFI)对体外受精结局的影响。方法:采用改良精子染色质扩散实验(SCD)对139例接受体外受精(IVF)的男方进行精子DFI检测,并根据精子DFI值将上述IVF患者分为:A组(DFI<17.6%)、B组(17.6%≤DFI≤30%)、C组(DFI>30%),根据单因素方差分析统计方法分析各组IVF受精率、卵裂率、优质胚胎率和妊娠结局的差异。结果:与A组比较,B组和C组正常形态精子率、精子前向活动力([a+b)%]、卵裂率、优质胚胎率均降低(P>0.05 vs B组,P<0.05 vs C组);与B组比较,C组正常形态精子率、精子前向活动力([a+b)%]、卵裂率、优质胚胎率均降低(P<0.05);与A组比较,B组和C组受精率均降低(P<0.05 vs B组,P<0.05 vs C组);与B组比较,C组受精率降低(P<0.05);A、B、C 3组间生化妊娠率、临床妊娠率差异无统计学意义(P>0.05)。结论:精子DNA碎片率升高不仅会导致精子前向活动力下降,还可导致IVF受精率、卵裂率、优质胚胎率下降,但对临床妊娠结局无明显影响。

Objective： To investigate the effects of sperm DNA fragmentation index on outcomes of IVF-ET. Methods： Sperm DNA frag- mentation index of 139 infertile couples participating in IVF program were analyzed by sperm chromatin dispersion （SCD） test. They were divided into three groups upon the size of sperm DNA fragmentation index： Group A （DFI 〈 17.6%）, Group B （17.6% ≤ DFI ≤ 30%）, and Group C （DFI 〉 30%）. IVF outcomes were analyzed by one-way ANOVA, including of fertilization rate, cleavage rate, high quality em- bryos rate and pregnancy outcomes. Results： Compared with group A, normal morphology sperm rate and sperm forward motility [（a＋b） %] as well as cleavage rate and high quality embryos rate were reduced in group B and group C （P〉0.05 vs group B, P〈0.05 vs group C ）; compared with group B, normal morphology sperm rate and sperm forward motility [（a＋b） %] as well as cleavage rate and high quality em- bryos rate were reduced in group C（ P〈0.05 ）; compared with group A, fertilization rate was reduced in group B and group C（ P〈 0.05 vs group B, P〈0.05 vs group C ）; compared with group B, fertilization rate was reduced in group C （ P〈0.05 ）, however, no statistic difference was observed on the biochemical pregnancy rate or clinical pregnancy rate in group A, group B and group C （P〉O.05）. Conclusion： The increase in sperm DFI can not only result in an decrease in the sperm forward motility or normal morphology rate, but also lead to a de- cline of IVF fertilization rate, cleavage rate, high quality embryos rate, however, outcomes of clinical pregnancy is not obviously affected.