年龄对不育男性精子DNA碎片率和精子形态的影响

Relationship between sperm morphology/sperm DNA fragment index and infertile male age

目的:评估年龄对男性不育患者精子DNA碎片率(DFI)及精子形态的影响。方法:回顾性分析2014-2018年本院生殖中心7067例精子形态学参数分析及2015-2017年1808例精子DFI分析的结果。根据患者年龄将其分为4组:≤25岁,26~35岁,36~45岁,及>45岁。采用单因素方差分析正常形态精子百分率、精子头部畸形百分率以及精子DFI的组间差异,并分析年龄与精子形态学参数及DFI的相关性。结果:随着年龄的增加,正常形态精子百分率和精子头部畸形率降低而精子DFI升高。≤25岁,26~35岁,36~45岁,及>45岁组的正常形态精子百分率分别为(6.14±2.39)%、(6.12±2.48)%、(5.95±2.32)%和(5.48±2.04)%,除≤25岁与26~35岁、≤25岁与36~45岁组间差异无显著性外,其余分组两两间差异均有显著性;各组精子头部畸形率分别为(86.55±5.07)%、(86.16±5.08)%、(85.82±5.27)%和(85.56±5.19)%,除≤25岁与26~35岁、26~35岁与>45岁、36~45岁与>45岁组间差异无显著性外,其余分组两两间差异均有显著性;各组精子DFI分别为(10.44±4.32)%、(12.26±6.84)%、(14.01±7.59)%和(20.08±10.14)%,各组两两间差异均有显著性。不育男性年龄与正常形态精子百分率(r=-0.07,P<0.01)、精子头部畸形率(r=-0.03,P<0.01)显著负相关,而与精子DFI(r=0.26,P<0.01)显著正相关。结论:不育男性的年龄影响DNA完整性和精子正常形态,随着年龄增加,DFI升高而正常形态精子百分率降低,且年龄与DFI及精子正常形态百分率均显著相关。

Objective: To analyze the relationship between infertile male age and sperm morphology, sperm DNA fragment index(DFI). Methods: The sperm morphological parameters of 7 067 infertile male patients from 2014 to 2018 and the sperm DFI of 1 808 from 2015 to 2017 were analyzed retrospectively.The patients were divided into 4 groups according to their age: ≤25 years old, 26-35 years old, 36-45 years old, and >45 years old. Comparison and correlation analysis among their sperm morphological parameters. DFI and age were conducted. Results: With the increase of age, the percentage of sperm with normal morphology and the rate of sperm head deformity decreased while the sperm DFI increased. The percentages of sperm with normal morphology in 4 groups were(6.14 ± 2.39)%,(6.12±2.48)%,(5.95±2.32)% and(5.48±2.04)%, respectively. There were significant differenc-es between the two groups except ≤25 years group and 26~35 years group, ≤25 and 36-45 years group. The rates of sperm head deformity in each group were(86.55 ± 5.07)%,(86.16 ± 5.08)%,(85.82± 5.27)% and(85.56± 5.19)%, respectively. There was no significant difference between ≤25 years group and 26-35 years group, 26-35 years group and >45 years group, 36-45 years group and >45 years group. The sperm DFI of each group was(10.44 ± 4.32)%,(12.26 ± 6.84)%,(14.01± 7.59)% and(20.08± 10.14)%, respectively. The infertile male age was significantly negatively correlated with percentage of sperm with normal morphology(r=-0.07, P<0.01), and sperm head deformity rate(r=-0.03, P<0.01), while positively correlated with sperm DFI(r=0.255, P<0.01). Conclusion: The infertile male age affects the normal morphology and DNA integrity of sperm. As the age increases, the percentage of sperm with normal morphology descends while the sperm DFI augments, and the age is significantly correlated with the percentage of sperm with normal morphology and sperm DFI.