精子功能检查与体外受精结局相关性研究

The Study of the Correlation Between Sperm Function Parameters Analysis and IVF Fertilization Outcome

目的：探讨东莞地区男性患者精子功能相关检查与体外受精－胚胎移植（ IVF－ET）结局的关系。方法随机选取本院25～44岁250例诊断为不育症需要接受IVF－ET助孕患者。将其根据受精情况分为正常受精组（指受精率＞30％）与受精障碍组（正常受精率≤30％），分析两组之间正常形态率、顶体酶活性、DNA碎片率的差异性。结果正常受精组精子正常形态百分率为（7．5±5．3）％，受精障碍组精子正常形态百分率为（3．2±2．8）％，差异具有统计学意义（P＜0．05）。正常受精组精子顶体酶活性为（87．50±30．70）μIU／106，受精障碍组精子顶体酶活性为（52．41±37．50）μIU／106，差异有统计学意义（P＜0．05）。正常受精组DNA碎片率为（14．27±3．69）％，受精障碍组精子 DNA碎片率为（12．94±4．00）％，差异无统计学意义（ P＞0．05）。结论顶体酶活性与受精率具有相关性，是预测受精率的一个有效指标，术前联合精子形态学检查可避免受精障碍的出现，可作为选择IVF或卵母细胞胞浆内单精子注射方案助孕的标准。 DNA碎片率与IVF－ET受精率无明显相关，其导致不育的影响可能不涉及受精问题。

Objective To study the correlation between sperm function parameters analysis and IVF fertilization outcome （ IVF-ET） in Dongguan.Methods According to the fertilization rate in IVF, semen samples randomly were selected and divided into the normal ferti-lization group （fertilization rate of 〉30%） and fertilization failure group （fertilization rate of≤30%）.Compare of two groups the sperm morphology index, acrosomal enzyme index, sperm DNA fragmentation index.Results The difference of the normal sperm morphology rate was significant （P〈0.05） with the fertilization failure group （3.2 ±2.8）%vs the normal fertilization group （7.5 ±5.3）%.The acrosom-al enzyme index in fertilization failure group was （52.41 ±37.50）μIU/106 sperm, vs the normal fertilization group （87.50 ±30.70）μIU/106 sperm, the difference was statistically significant （ P〈0.05）.DNA fragmentation Index in fertilization failure group was （12.94 ±4.00）%vs the normal fertilization group （14.27 ±3.69）%, with no statistical significance （P〉0.05）.Conclusion The index of acrosomal en-zyme is in highly correlation to fertilization rate a valid predictor for fertilization rate.Acrosomal enzyme analysis combined sperm morpholo-gy before IVF can avoid the occurrence of fertilization failure.Both can be used as standard of IVF or ICSI choice.DNA fragment rate and IVF -ET fertilization rate has no obvious correlation, maybe the cause of infertility may not involving the effect of fertilization.