精子CMA3阳性率与IVF受精率的相关性研究

Association between sperm CMA3 positive rate and IVF fertilization rate

目的探讨精子色素酶A3(CMA3)阳性率与IVF受精率之间的相关性。方法收集2015年4月至2016年7月因单纯输卵管性不孕在我院生殖医学科行常规IVF助孕的156个周期,以受精率<25%为低受精,根据受精率不同分为正常受精组(134个周期)和低受精组(22个周期)。取卵日,将授精后剩余的洗涤精液行精子浓度和活动率分析,并将精子进行CMA3染色。比较两组优选后的精子参数,分析IVF受精率与精子参数及CMA3阳性率的关系。结果与正常受精组比较,低受精组精子CMA3阳性率显著升高[(20.0±4.2)%vs.(30.7±2.3)%],优选后前向运动精子的百分率显著降低[(90.4±4.8)%vs.(74.3±3.4)%](P<0.05);两组精子浓度比较无显著性差异(P>0.05)。IVF受精率与优选后的前向运动精子百分率呈正相关(r=0.76,P<0.01)。精子CMA3阳性率与优选后前向运动精子百分率(r=-0.82,P<0.01)及IVF受精率(r=-0.83,P<0.01)呈显著负相关,与精子浓度则无显著相关性(P>0.05)。结论精子CMA3阳性率与IVF受精率负相关,但其具体机制尚需进一步研究探讨。

Objective：To explore the correlation between sperm CMA3 positive rate and IVF fertilization rate.Methods：A total of 156 cycles of conventional IVF of the patients with simple oviducal infertility were collected in this study.The cycles were divided to normal fertilization group（n=134）and low fertilization group（n=22）in according with fertilization rate25% for low fertilization.On the day of oocyte retrieval,sperm concentration,sperm motility in the remain semen was examined and the sperms were conducted with CMA3 staining after washing and insemination.The sperm parameters were compared between the two groups and the correlation between IVF fertilization rate sperm parameters and CMA3 positive rate was analyzed.Results：Compared with normal fertilization group,the sperm CMA3 positive rate[（20.0±4.2）%vs.（30.7± 2.3）%] was significantly increased,and the percentage of progressive motile sperm was significantly decreased [（90.4±4.8）% vs.（74.3±3.4）%]in low fertilization group（P〈0.05）.The sperm concentration was not statistically different between the two groups（P〈0.05）.The IVF fertilization rate was significantly positively correlated with the percentage of progressive motile sperm before selection（r=0.76,P〈0.01）.Sperm CMA3 positive rate was significantly negatively correlated with the percentage of progressive motile sperm（r=-0.82,P〈0.01）or IVF fertilization rate（r=-0.83,P〈0.01）,but was not significantly correlated with sperm concentration（P〉0.05）.Conclusions：Sperm CMA3 positive rate is associated with IVF fertilization rate,but its specific mechanism still needs further study.