摘要
目的系统评价不同精子DNA断裂指数检测方法与IVF/ICSI结局的关系。方法计算机检索Cochrane Library、Pub Med、EMbase、中国生物医学文献数据库、万方数据库等,收集符合纳入标准的研究,检索时限均为从建库至2015年3月,并追溯纳入研究的参考文献和手工检索相关会议资料。由两位研究者按照纳入与排除标准独立筛选文献、提取资料和评价质量后,采用Rev Man5.2软件进行Meta分析。结果共纳入16个病例对照研究,共计3105例患者,meta分析结果显示,若采用TUNEL(末端脱氧核苷酸转移酶介导的脱氧尿苷三磷酸标记),精子DFI升高显著增加IVF/ICSI流产率(P<0.01),DFI降低显著提高IVF/ICSI妊娠率(P<0.01);若采用SCSA(染色质结构分析),DFI升高仅显著增加ICSI流产率(P=0.05),对ICSI妊娠率及IVF流产率/妊娠率均无显著影响。结论不同精子DFI检测方法对IVF/ICSI结局的影响不一致,统一研究对象的选择标准,对不同检测方法进行分类研究可能会得到较为可靠的结论。
Objective：The aim of this systematic review was to evaluate the controversial association between sperm DNA fragmentation index and outcome after IVF/ICSI.Methods：Original literatures for this review were searched with databases of Cochrane Library,Pub Med,EMbase,Ovid and Esmbase,etc.From databases establishment to March 2015.All the case-control studies on the association between sperm DNA fragmentation and outcome after IVF/ICSI were included and the quality of them was assessed.Meta-analysis was conducted using the Cochrane Collaboration′s Rev Man 5.2 software.Results：Meta-analysis showed that high-level sperm DNA fragmentation by using TUNEL has a significantly detrimental effect on outcome of IVF/ICSI,with decreased pregnancy rate and increased miscarriage rate（P〈0.01）.By using SCSA,high-level sperm DNA fragmentation only has a marginal detrimental effect on miscarriage rate of ICSI.Conclusion：Diverse method of sperm sperm DNA fragmentation index detection has different influence on IVF/ICSI outcome.The stratified analysis by type of procedure may get more reliable conclusions.
出处
《中国优生与遗传杂志》
2016年第3期104-108,共5页
Chinese Journal of Birth Health & Heredity
