男性叶酸代谢功能与辅助生殖技术结局的相关性研究

Association between folate metabolism in males and outcome of assistant reproductive technology

目的·研究男性叶酸代谢相关基因亚甲基四氢叶酸还原酶(methylenetetrahydrofolate reductase,MTHFR)C677T多态性及同型半胱氨酸(homocysteine,HCY)水平对辅助生殖技术(assisted reproductive technology,ART)妊娠结局的影响。方法·观察接受辅助生殖治疗的285对不孕不育夫妇,收集男方精液质量、血清HCY浓度和MTHFR基因型等资料,并对他们助孕情况进行回顾性分析。根据HCY水平分为高HCY组和正常HCY组,根据MTHFR基因型结果分为叶酸代谢障碍高风险(TT)组和非TT组,两两组合,以非TT正常HCY组为参照组进行比较。结果·各组精液质量对比差异无统计学意义(P>0.05)。非TT高HCY组及TT高HCY组与参照组比较,受精率显著降低(P=0.001,P=0.002);非TT高HCY组的优胚率明显低于参照组(P=0.038)。妊娠率及流产率差异无统计学意义(P>0.05)。结论·高HCY血症可能会影响辅助生殖技术的受精率,MTHFR基因多态性的检测结果有助于提醒受孕人群及时补充叶酸。

Objective·To investigate the association between polymorphisms in methylenetetrahydrofolate reductase(MTHFR),serum homocysteine(HCY)concentration and outcome of assistant reproductive technology(ART).Methods·A retrospective study was conducted in 285 infertile couples who underwent ART.Sperm quality,serum HCY concentration and MTHFR genotype of the males in these couples were collected.According to the results of MTHFR C677T and serum HCY of males,they were divided into four groups,i.e,TT+high HCY,TT+normal HCY,NOT TT+high HCY,and NOT TT+normal HCY(as control).Results·There was no significant difference in the frequency distribution of oligoasthenozoospermia of four groups(P>0.05).The fertilization rates were significantly lower in patients with high plasma HCY levels(P<0.05).The rates of effective embryo in NOT TT+high HCY group were significantly lower(P<0.05).Accumulated pregnancy rates and early abortion rates were not significantly different among four groups(P>0.05).Conclusion·High serum HCY of males may affect outcome of ART.The detection of MTHFR gene polymorphisms helps to remind supplement folic acid in time.