精液处理前、后精子3项对IVT-ET结局的相关性分析

Correlative analysis of three sperm indexes and IVT-ET outcome after semen treatment

目的探讨精液处理前、后精子3项对体外受精-胚胎移植(IVT-ET)结局的相关性。方法回顾性统计分析西南医科大学附属医院298例行IVT-ET治疗的男方精液,按照WHO标准对处理前精液进行常规分析,Vitrolife密度梯度离心结合上游法处理精子后分析记录精液各项参数,受精并进行序贯培养至第3天观察统计。结果精液处理前后精子总活力、正常形态精子百分率、精子密度等差异有统计学意义(P<0.05);处理后精子正常形态率与受精率、卵裂率呈正相关(r=0.487、0.250,P<0.05);处理后精子总活力与受精率、卵裂率呈正相关(r=0.249、0.272,P<0.05);处理后精子密度与2原核(PN)、多PN受精率呈正相关(r=0.609、0.243,P<0.05)。结论根据取卵当日处理后的精子参数对选择合适的受精方式更有预测价值。

Objective To investigate the correlation between three sperm indexes and the outcome of in vitro fertilization and embryo transfer（IVT-ET）before and after semen treatment.Methods The semen derived from 298 male patients treated with IVT-ET from the Affiliated Hospital of Southwest Medical University was retrospectively analyzed.Routine analysis of semen before treatment was performed according to the WHO standard.Vitrolife density gradient centrifugation combined with upstream method was used to analyze sperm parameters after sperm analysis,and the observation and statistics were performed after fertilization and sequential culture to day 3.Results The total viability of spermatozoa before and after semen treatment,the percentage of normal spermatozoa,sperm density,and other differences were statistically significant（P〈0.05）;The normal sperm morphology rate was positively correlated with fertilization rate（r=0.487,P〈0.01）and cleavage rate（r=0.250,P〈0.05）;The sperm vitality of post-processed semen was positively related to the fertilization rate（r=0.249,P〈0.05,）;and significantly cleavage rate（r=0.272,P〈0.05）;After treatment,sperm density was positively correlated with 2 PN（r=0.609,P〈0.01）and multiple PN fertilization rates（r=0.243,P〈0.05）.Conclusion Our experimental results indicate that the parameters of post-processed sperm treated at the day when the oocytes were collected may be more helpful in predicting the fertilization rate and cleavage rate of IVF-ET.Therefore,the IVF-ET treatment protocols should be chose based on the normal sperm morphology rate and sperm vitality after semen treatment.