精子DNA损伤与精液参数、胚胎发育及早期自然流产相关性分析

Association of sperm DNA integrity with sperm parameters and embryonic development and early spontaneous abortion

目的:探讨精子DNA完整性与精液参数、体外受精-胚胎移植(IVF-ET)/卵胞浆内单精子注射(ICSI)胚胎发育及早期自然流产的关系。方法:采用改良精子染色质扩散实验(SCD)检测1160个辅助生殖技术(ART)周期(899对夫妻)中精子DNA的完整性,以精子DNA碎片指数(DFI)为参数,将患者分为高DFI组(DFI≥25%)和低DFI组(DFI <25%),根据采用不同的体外受精方式将两组又分为IVF亚组和ICSI亚组,比较组间精液参数、受精率、卵裂率、可移植胚胎率、优胚率、临床妊娠率、早期流产率、分娩率。结果:精液参数(精液密度、精子活力、正常精子形态率)与DFI显著相关,差异具有统计学意义(P <0. 05),低DFI组中的IVF亚组的受精率、分娩率显著高于高DFI组,早期流产率显著低于高DFI组,差异具有统计学意义(P <0. 05),其余各亚组间的卵裂率、可移植胚胎率、优胚率、临床妊娠率均差异无统计学意义(P> 0. 05)。结论:精子DNA完整性与精液密度、精子活力、正常形态精子百分率呈负相关,对IVF的受精率、早期流产率和分娩率有显著影响,故建议在DFI≥25%时,优先考虑ICSI授精。同时建议将精子DNA完整性作为辅助生殖的常规精液指标。

Objective：To study the association of sperm DNA integrity with sperm parameters and embryonic development of ART and early spontaneous abortion. Methods： The integrity of sperm DNA in 1160 assisted reproductive technology （ART） cycles （899 couples） was examined using modified sperm chromatin diffusion experiment （SCD）. The DNA fragment index （DFI） was used to divide patients into high DFI group （DFI） and low DFI group （DFI）. The patients were divided into high DFI group （ DFI≥25% ） and low-DFI （ DFI 〈 25% ）. The two groups were divided into IVF subgroups and ICSI subgroups according to different IVF methods. Compared of semen parameters, fertilization rate, cleavage rate, transplantable embryo rate, embryo rate, clinical pregnancy rate, early abortion rate and delivery rate were compared. Results ： Semen parameters which was sperm density, sperm vitality, sperm deformity rate was associated with DFI was significant correlation （ P 〈 0.05 ）. The fertilization rate and delivery rate of IVF subgroups in low DFI group were significantly higher than that in high DFI group, and the early abortion rate was significantly lower than that in high DFI group （ P 〈 0.05 ）. There was no significant difference in the cleavage rate, embryo rate, embryo rate and clinical pregnancy rate among the other subgroups （ P 〉 0.05 ）. Conclusion： Sperm DNA integrity was negatively correlated with sperm density, sperm motility, and percentage of normal sperm. And the integrity had a significant impact on fertility rate, early spontaneous abortion rate and parturition rate of IVF subgroup. It was recommended that ICSI be preferred when DFI is greater than 25%. And the sperm DNA integrity was recommended as a routine semen indicator for assisted reproduction.