精子形态对体外受精结局的影响

The influence of sperm morphology on IVF/ICSI outcome

目的 探讨精子形态对常规体外受精（IVF）及单精子卵胞浆内注射（ICSI）周期的受精率、卵裂率、优胚率及妊娠率的影响.方法 将2011年6月至2014年6月在我院行IVF/ICSI治疗的周期根据精子形态进行分组：IVF周期分为A组（正常精子形态＜2％）,B组（2％≤正常精子形态＜4％）,C组（正常精子形态≥4％）;ICSI周期分为D组（正常精子形态＜2％）,E组（2％≤正常精子形态＜4％）,F组（正常精子形态≥4％）,分别比较各组间受精率、卵裂率、优胚率及妊娠率的差异.结果 IVF周期中C组受精率显著高于B组和A组,差异具统计学意义（P＜0.05）,卵裂率、优胚率及妊娠率在A、B、C组之间则无显著性差异（P＞0.05）;ICSI周期中D组、E组、F组受精率、卵裂率、优胚率及妊娠率无显著性差异（P＞0.05）.结论 畸形精子症会影响IVF周期的受精率,对ICSI周期的受精率无显著性影响.

Objective To investigate the effects of sperm morphology on the fertilization rate, cleavage rate, embryo rate and pregnancy rate of conventional in vitro fertilization （IVF） or intracytoplasmic sperm injection （IVF/ICSI） cycles. Methods The patients who received the IVF/ICSI treatment cycles from June 2011 to June 2014 in our hospital, were divided into groups according to sperm morphology： IVF cycles is divided into group A （normal sperm morphology 〈 2%） and group B （2% or less of normal sperm morphology 〈 4%）, group C （normal sperm morphology 4% or higher）; ICSI cycles divided into D group （normal sperm morphology group 〈 2%）, E （2% or less of normal sperm morphology 〈 4%）, group F （normal sperm morphology 4% or higher）. The fertilization rate, cleavage rate, optimal embryo rate, pregnancy rate between differences groups were comparatively analyzed. Results In the IVF cycles,the fertilization rate of group C was significantly higher than that of group A and group B. There were no significant difference between the group A, B,and C in the cleavage rate, optimal embryo rate and pregnancy rate; In the ICSI cycles, there were no significant difference between the group D, E and F in the fertilization rate, cleavage rate, optimal embryo rate and pregnancy rate. Conclusion Teratozoospermia may affect the fertilization rate oflVF cycle, but no significant influence on that oflCSI cycles.