精子DNA完整性与夫精人工授精结局的相关性研究

Correlation Between Sperm Dna Integrity and Outcome of Artificial Insemination with Husband＇S Semen

【目的】探讨精子 DNA 完整性与夫精人工授精（AIH ）结局的关系。【方法】应用 PureceptionTM密度梯度离心法对82对不孕夫妇共108个 AIH 治疗周期进行精液处理，在精液处理前后采用精子染色质结构分析（SCSA）检测精子 DNA 完整性[精子 DNA 碎片指数（DFI）、高可染性精子指数（HDS）]，采用计算机辅助精液分析（CASA）检测精子浓度、前向运动（PR）精子百分比，采用改良巴氏染色法检测精子正常形态率。【结果】①108个 AIH 周期的临床妊娠率为17．59％（19／108），精液处理后精子 DFI 、HDS 较处理前明显降低（ P ＜0．05），精子浓度、PR 精子百分比、精子正常形态率明显升高（ P ＜0．05）。②根据 AIH 结局分为临床妊娠组和非临床妊娠组，两组精液处理前的精子 DFI 分别为（17．02±4．14）％、（22．61±9．71）％，HDS 分别为（7．33 ± 2．46）％、（9．07±3．47）％，两组比较其差异均具有显著性（ P ＜0．05）；③根据精液处理前的精子DFI 情况分为三组：A 组（DFI ＞30％ ）、B 组（30％≥ DFI ＞20％ ）、C 组（DFI ≤20％ ），三组临床妊娠率分别为0％、12．50％、22．54％，C 组明显高于 A 组与 B 组，且各组之间比较差异均具有显著性（ P ＜0．05）。【结论】精子 DNA 完整性与 AIH 结局密切相关，精子 DFI 可作为参考指标用于预测 AIH 结局。

[Objective] To explore the relationship between sperm DNA integrity and outcome of artificial insemination with husband＇s semen （AIH） .[Methods] The semen specimens were prepared by Pureception TM gradient centrifugation technique and used for a total of 108 AIH cycles in 82 infertile couples .Before and after preparation ,the sperm DNA integrity [DNA fragmentation index （DFI） ＆amp; high DNA stainability （HDS）] was detected by sperm chromatin structure assay （SCSA ） .And sperm concentration and percentage of pro‐gressively motile （PR） sperm were detected by computer‐aided sperm analysis （CASA ） and the proportion of normal sperm morphology was detected by modified Papanicolaou staining .[Results] The clinical pregnant rate of 108 AIH cycles was 17 .59% .After preparation ,sperm DFI and HDS significantly decreased （ P 〈0 .05） while sperm concentration ,percentage of PR sperm and proportion of normal sperm morphology signifi‐cantly increased （ P 〈 0 .05） .According to the outcome of AIH ,the cycles were divided into pregnancy and non‐pregnancy groups ,the sperm DFI pre‐preparation was （17 .02 ± 4 .14）% and （22 .61 ± 9 .71）% and sperm HDS （7 .33 ± 2 .46）% and （9 .07 ± 3 .47）% respectively .And the differences were both statistically significant （ P 〈 0 .05） .3 .According to the sperm DFI before preparation ,the cycles were divided into 3 group of A （DFI 〉 30% ） ,B （30% ≥ DFI 〉 20% ） and C （DFI ≤ 20% ） . And the clinical pregnancy rates were 0% , 12 .50% and 22 .54% respectively .[Conclusion] Sperm DNA integrity is positively correlated with the preg ‐nancy outcomes of AIH .And sperm DFI may be used as a reference index for predicting the outcome of AIH .