精子核蛋白组型转换与精液参数、胚胎发育的相关性分析

Association of sperm-nucleoprotein transition with sperm parameters and embryo development

目的 探讨精子核蛋白组型转换与精液参数、胚胎发育质量的相关性及其对接受人类辅助生殖（ART）治疗患者妊娠结局的影响. 方法 2011年4月至2012年4月,检测676例接受ART治疗的不育男性精子核蛋白组型转换,分析核蛋白组型转换与精液参数、精子DNA损伤、顶体酶活性、受精率、卵裂率、优质早胚发育、囊胚形成率及妊娠结局之间的相关性. 结果 核蛋白组型转换异常组（异常率＞30％）162例,精子浓度为（66.5±4.6）× 109/L,精子总数为（149.2±9.9）×109/L,（a＋b）级精子为（51.2.±1.3）％,顶体酶活性为（72.2±3.3） mU/106精子,而正常组（异常率≤30％）514例,精子浓度为（91.9±2.7）×109/L,精子总数为（240.0±8.0）×109/L,（a＋b）级精子为（57.3±0.8）％,顶体酶活性为（85.7±1.9） mU/106精子,两组比较差异有统计学意义（P＜0.01）.核蛋白转换异常组精子DNA碎片指数（DFI）为（17.3±1.0）％,显著高于正常组（14.6±0.5）％（P＜0.01）.核蛋白转换异常组卵裂率、D3和D5优质胚胎率、D5囊胚形成率和总囊胚形成率分别为95.0％、34.2％、1.28％、22.4％和38.6％,均显著低于正常组的96.9％、38.2％、2.70％、27.9％和46.4％（P＜O.01）.同时,异常组自然流产率为12.3％,正常组为4.7％（P＜0.01）,而临床妊娠率、生化妊娠率和异位妊娠率两组间比较差异均无统计学意义（P＞0.05）. 结论 精子核蛋白组型转换与精液参数、精子DNA损伤及顶体酶活性密切相关,同时会影响胚胎发育质量,可增加流产概率.因此,行ART治疗前有必要对精子核蛋白组型转换进行评估.

Objective To investigate the correlation between sperm-nucleporotein transition and sperm parameters and embryo development, also to evaluate the influence of pregnancy out comes of assisted reproductive technology （ART）. Methods Sperm-nucleoprotein transition assay of a total of 676 patients underwent ART treatment were detected by aniline blue staining, and the correlation analysis between sperm- nucleoprotein transition and sperm parameters, DNA damage, acrosin activity, fertilization rate, cleavage rate, quality of early embryo development as well as blastocyst formation rate was performed. Results The sperm concentration, （a±b）% sperm, sperm count and acrosin activity was （66.5±4.6）× 109/L, （149.2± 9.9） ×109/L, （51.2±1.3）% and （72.2±3.3） mU/106 sperm in abnormal group, and （91.9±2.7） ×109/L, （240.0±8.0） ×109/L, （57.3±0.8） % and （ 85.7± 1.9） mU/106 sperm in normal group, which reached sig- nificant difference （P〈0.01）. DNA fragmentation index （DFI） was （ 17.3~ 1.0）% in abnormal group,which was significantly higher than （14.6±0.5） % in normal group. The cleavage rate of 95.0%, D3/D5 high qual- ity embryo rates of 34.2% and 1.28%, D5 blastocyst formation rate and the total rate of blastocyst formation rate of 22.4% and 38.6% in abnormal group, which were significantly lower than that in normal group （96.9%, 38.2%, 2.70%, 27.9% and 46.4%） （P〈0.01）. The rate of spontaneous abortion was 12.3% inabnormal group, which was significantly higher than that in normal group （4.7%） （P〈0.01）. However, there was no significant difference in biochemical pregnancy rate and ectopic pregnancy rate between the 2 groups （P〉0.05）. Conclusions Sperm-nucleoprotein transition was positively related with sperm param- eters, DNA damage, acrosin activity, and also has an adverse effect on embryo development and the out- comes of ART. It is suggested that the sperm-nucleoprotein transition should be detected before ART.