摘要
近年来，涌现出许多重要的男性不育诊疗新技术。本研究旨在探讨精@DNA完整性与精子空泡率检测对以男性不育因素行IvF或IcsI治疗的不育症的治疗结局。本研究针对152对不育症夫妻行ART技术前进行的精子DNA碎片率与形态学超高倍分析进行队列研究。我们发现对妊娠结局最有预测价值的DNA碎片率切点值为25．5％，阴性预测值为72．7％（P=0．02）。在对空泡率的研究中发现，3、4级的空泡精子的最有预测价值切点值为73．5％，阴性预测值为39．4％（P=0．09），差异无统计学意义。总之，当精子DNA碎片率大于25％时，IVF失败的概率增大，而精子形态学超高倍检测结果对预测患者的妊娠结局无明显获益。
Over the last years, major improvements in the field of male infertility diagnosis have been achieved. The aim of this study was to determine the diagnostic usefulness of sperm DNA integrity and sperm vacuolisation for predicting outcome in infertile couples undergoing in vitroferti lisation （IVF） and intracytoplasmic sperm injection （ICSI） treatments. A cohort study from 152 infertile couples undergoing sperm DNA fragmentation and high-magnification tests prior to an assisted reproduction treatment was designed. We found that the most predictive cutoff for pregnancy was 25.5% of DNA fragmentation with a negative predictive value of 72.7% （P=0.02）. For the degree of vacuolisation, the best predictor of pregnancy was 73.5% of vacuolated sperm grades Ⅲ ＋ Ⅳ with a negative predictive value of 39.4% （P=0.09）, which was not statistically significant. In conclusion, sperm DNA fragmentation greater than 25.5% could be associated with higher probability of failure IVF treatment. Regarding the results of the sperm analysis at high magnification, they do not allow us to predict whether or not oatients will become pregnant.
