精子DNA碎片指数阈值与体外受精-胚胎移植结局的相关性研究

Impact of threshold value of sperm DNA fragmentation on IVF-ET outcome

目的研究不同的精子DNA碎片率(SDF)阈值水平与IVF-ET结局的关系。方法对纳入病例的临床资料进行回顾性分析,并将10%、20%和30%分别作为SDF阈值进行分组,以比较不同SDF阈值水平下精液常规参数、顶体酶活力以及IVF-ET生殖结局的差异。结果在不同SDF阈值(10%、20%或30%)水平下,SDF高低组之间的精液常规各项参数、顶体酶活力均无统计学差异(P>0.05)。SDF阈值设为10%时,SDF高低组之间的IVF-ET结局无统计学差异(P>0.05);SDF阈值设为20%或30%时,高SDF组患者的优质胚胎率、临床妊娠率均低于低SDF组,差异有统计学意义(P<0.05);SDF阈值设为30%时,高SDF组患者的受精率也低于低SDF组,差异有统计学意义(P<0.05)。结论当精子SDF>20%时,可能对患者的辅助生殖结局产生负面影响,建议给予适当的抗氧化治疗,待患者的精子SDF≤20%时,再进入IVFET助孕周期。

Objective： To evaluate the correlation between the threshold value of sperm DNA fragment （SDF） and IVF-ET outcome. Methods： The clinical data were retrospectively analyzed. The patients were divided into three groups according to the set threshold value of SDF （10%,20% and 30%, respectively）. Differences in semen routine parameters, acrosin activity, and IVF-ET outcome were compared among the three groups. Results： There was no significantly difference in semen routine parameters and acrosin activity among the three groups with the different SDF threshold value （10%,20% or 30%） （P〉0.05）. When SDF threshold value was set as 10% there were no significantly differences in high quality embryo rate and clinical pregnant rate of IVF-ET between higher SDF group and lower SDF group （P〉0.05）. When the SDF threshold value was set as 20% or 30% ,high-quality embryo rate and clinical pregnancy rate in higher SDF group were significantly lower than that in lower SDF group （P〈0.05）. The fertilization rate was also significantly decreased in higher SDF group when the threshold value was set as 30% （P〈0.05）. Conclusions. When the SDF threshold value was more than 20%,the higher SDF may have a negative impact on the assisted reproductive outcome of the patients. It is recommended to give appropriate anti- oxidative therapy. When the patient＇s sperm SDF is decreased to ≤20% after treatment,and then enters the IVF-ET cycle.