精子形态对体外受精－胚胎移植治疗结局的影响

Inlfuence of Human Normal Sperm Morphology Rate on the Clinical Outcomes in IVF-ET

目的：探讨正常形态精子百分率对体外受精-胚胎移植（IVF-ET）治疗结局的影响。方法回顾分析于生殖医学中心接受治疗的323个IVF-ET周期，采用WHO第5版精液质量分析标准严格进行精子形态学分析，研究分3组：A组：1%≤正常形态精子百分率﹤2.5%，中度畸形组；B组：2.5%≤正常形态精子百分率﹤4%，轻度畸形组；C组：正常形态精子百分率≥4%，正常形态组。比较各组间受精率、卵裂率、可移植胚胎率、优质胚胎率、着床率、临床妊娠率。结果各组间女方年龄、不孕年限、男方年龄差异均无统计学意义（P﹥0.05）。三组患者间多精受精率、双原核卵裂率、可移植胚胎率、优质胚胎率、着床率、临床妊娠率等差异均无统计学意义（P﹥0.05），但随着正常形态精子比率升高，受精率随之升高，三组之间差异有统计学意义（P﹤0.05）。结论在常规IVF-ET中，精子形态可在一定程度上影响卵子的受精率，但与胚胎质量、妊娠结局无明显相关性。

Objective To study the relationship between the rate of human normal morphology sperm and the clinical outcomes of in vitro fertilization-embryo transfer （IVF-ET） treatment.MethodsThis study retrospectively analyzed 323 IVF-ET cycles. Sperm morphology was evaluated strictly according to the WHO criterion. Based on the results of morphological evaluation, the 323 cycles were divided into three groups, which deifned morphologically normal sperm≥1% and﹤2.5% as group A,≥2.5% and﹤4% as group B, and≥4% as group C respectively. The relationship between sperm morphology and the rates of fertilization, cleavage, quality embryos, implantation, clinical pregnancy were compared and analyzed among these three groups.Results There was no signiifcant difference among the three groups in female age, infertile years, male age （P﹥0.05）. No statistically signiifcant differences were observed in the rates of multi-PN fertilization, cleavage, embryo quality, high quality embryos, implantation, clinical pregnancy （P﹥0.05）. Meanwhile, there was statistically signiifcant difference in the rate of fertilization among the three groups （P﹤0.05）, following with increase of rate of normal morphology sperm, the fertilizaton was signiifcantly increased.Conclusion Sperm morphology affects the fertility rate of IVF-ET, however, has no signiifcant impact on embryo quality and clinical outcomes of IVF-ET.