精子核蛋白组型转换对胚胎体外发育的影响

Influence of sperm nucleoprotein transition on in vitro embryo development

目的探讨精子核蛋白组型转换与精子DNA损伤、精子形态以及胚胎发育质量的相关性，评价其在辅助生殖中的诊断价值。方法检测437例接受体外受精-胚胎移植治疗的不育男性精子核蛋白组型转换率，分析核蛋白组型转换率与精子异常形态率、精子DNA损伤率、受精率、正常受精率、卵裂率、可移植胚胎率、受精第3天（D3）优质胚胎率、囊胚形成率以及优质囊胚率之间的相关性。结果核蛋白组型转换正常A组（异常率≤30％，135例）与核蛋白组型转换异常B组（30％〈异常率〈60％，170例）相比，精子正常形态率、精子DNA损伤、受精率、正常受精率、卵裂率、可移植胚胎率、D3优质胚胎率、囊胚形成率、优质囊胚率之间差异无统计学意义（P〉0．05）；核蛋白组型转换异常C组（异常率≥60％，132例）精子异常形态率、精子DNA损伤、正常受精率、可移植胚胎率、D3优质胚胎率、优质囊胚率与A组相比差异具有统计学意义（P〈0．01），而受精率、卵裂率和囊胚形成率同A组比较差异无统计学意义（P〉0．05）。结论精子核蛋白组型转换异常可能与精子DNA损伤、精子形态以及胚胎发育密切相关。在辅助生殖技术治疗前，对男性的精子核蛋白组转换进行评估有临床价值。

Objective To correlate sperm nucleoprotein transition （SNT） with sperm morphology, DNA damage and embryo development, and assess its value for assisted reproductive technology （ART）. Methods The SNT of 437 infertile men underwent ART were assayed, and its correlation with sperm morphology, DNA damage, fertilization rate, normal fertilization rate, cleavage rate, available embryo rate, D3 high quality embryo rate, blastocyst formation rate and high quality blastocyst rate were analyzed. Results The normal morphology rate of sperms, DNA damage, fertilization rate, normal fertilization rate, cleavage rate, embryo transfer rate （ETR）, D3 high quality embryo rate, blastocyst formation rate （BFR） and high quality blastocyst in normal males （Group A, abnormal rate ≤ 30%, 135 subjects） did not significantly differ from those with an abnormal rate between 30% and 60% （Group B, 170 subjects） （P〉 0.05）. For those with an abnormal rate of above 60% （Group C, 132 subjects）, the sperm normal morphology rate, DNA damage, normal fertilization rate, ETR, D3 high quality embryo rate, high quality blastocyst rate were significantly lower compared with Group A （P〈0.01）, while no significant difference was found in fertilization rate, cleavage rate and BFR between groups A and C （P〉 0. 05）. Conclusion SNT is related with sperm morphology rate, DNA damage and embryo development, and should be assessed before ART.