精子顶体精氨酸酰胺酶测定在体外受精-胚胎移植妊娠结局中的价值研究

Predictive value of sperm arginine amidase enzyme in the outcome of in vitro fertilization-embryo transfer

目的研究精子顶体精氨酸酰胺酶在体外受精-胚胎移植(IVF-ET)中的应用价值。方法选择349个IVF治疗周期,其中精氨酸酰胺酶高值组162个周期,精氨酸酰胺酶低值组187个周期。比较两组间的受精率、正常受精率、卵裂率、优质胚胎率以及新鲜移植周期的生化妊娠率、临床妊娠率、流产率及活产率等指标。结果精子精氨酸酰胺酶高值组的受精率(78.74%)高于低值组(76.07%,P<0.05),而卵裂率高值组(98.24%)低于低值组(99.58%,P<0.05)。两组间正常受精率和优质胚胎率比较无统计学差异。高值组新鲜移植周期的临床妊娠率(58.75%)及活产率(52.50%)均明显高于低值组(44.00%,P<0.05;33.00%,P<0.01)。两组间生化妊娠率和流产率比较无统计学差异(P>0.05)。结论精子精氨酸酰胺酶活性与IVF-ET精卵结合有一定关系,并对妊娠结局有一定的指导作用。

Objective To examine the effects of arginine amidase activity variations to the in vitro fertilization-embryo transfer （IVF-ET） cycles. Methods The arginine amidase activity was analyzed for 349 IVF- ET cycles, there were 162 cycles with high arginine amidase activity and 187 cycles with low arginine amidase activity. We evaluated the rates of fertilization, cleavage, quality embryos of IVF, and biochemical pregnancy, clinical pregnancy, abortion and live birth of fresh embryos transfer cycles. Results The fertilization rate was significantly higher in high arginine amidase activity group （78.74%） than low activity group （76.07%, P〈 0.05）, while the cleavage rate was lower in high arginine amidase activity group （98.24%） than low activity group group （99.58%, P〉0.05）. There were no significant difference in the rates of normal fertilization and quality embryos. The rates of clinical pregnancy （58.75%） and live birth （52.50%） were significantly higher in high arginine amidase activity group than in low group （44.00%, P〈0.05; 33.00%, P〈0.01）. There was no significant difference in the rates of biochemical pregnancy and abortion between two groups （P〉0.05）. Conclusion The sperm arginine amidase activity may affect the fertilization of IVF-ET. It helps predicting the outcome of fresh embryos transfer cyclesl