精子DNA碎片化指数与体外受精-胚胎移植结局的关系

Relationship between DNA fragmentation index of sperm and outcome of in vitro fertilization-embryo transfer

目的:探究精子DNA碎片化指数(DNA fragmentation index,DFI)与体外受精-胚胎移植的实验室指标和临床结局的关系。方法:选取在本院生殖中心就诊且符合纳入标准的90对夫妇为研究对象,以DFI值<15%、15%～30%、>30%分为正常组、低损伤组、高损伤组。统计男女双方年龄、男方精液常规参数、女方获卵数、受精率、卵裂率、优胎率、囊胚形成率、妊娠率和流产率,分析3组之间各指标的差异。结果:3组的男女双方年龄、男方精液常规指标、女方获卵数无明显差异(P> 0.05)。3组间受精率、卵裂率差异亦无统计学意义(P> 0.05);高损伤组的优胎率(59.65%±28.93%)和囊胚形成率(13.49%±17.74%)较正常组(74.34%±21.56%,31.27%±20.54%)明显降低(P <0.05);而与正常组相比,低损伤组囊胚形成率(21.00%±22.02%)明显降低(P <0.05)。高损伤组妊娠率(66.67%)较正常组(86.67%)明显降低(χ~2=4.356,P <0.05)。3组间的流产率无明显差异(χ~2=0.078,P> 0.05)。结论:DFI值的升高可能与优胎率、囊胚形成率以及妊娠率的降低有关,而与受精率、卵裂率和流产率无明显关联。

Objective: To investigate the relationship between DNA damage of sperm and outcomes of in vitro fertilization-embryo transfer( IVF-ET). Methods: We selected 90 couples undergoing the IVF-ET in the reproductive center of Changzhou Women' s and Children' s Healthcare Hospital. These patients were divided into three groups with DFI values < 15%,15%- 30%,> 30% respectively as normal group,lower damage group and higher damage group. The ages of male and female,semen routine parameters of male,number of ova obtained by female,fertilization rates,cleavage rates,good quality embryo rates,blastocyst formation rates,pregnancy rates and abortion rates were collected and calculated,and then we analyzed the differences among the three groups. Results: There was no significant difference in the ages of male and female,semen routine parameters of male,and numbers of ova in the three groups ( P > 0. 05). There was no statistically significant difference in the rates of fertilization and cleavage between the three groups( P > 0. 05). Compared with normal group ( 74. 34%± 21. 56%,31. 27%± 20. 54%),the good quality embryo rates( 59. 65%±28. 93%) and blastocyst formation rates( 13. 49%± 17. 74%) of higher damage group were significantly decreased( P < 0. 05). In lower damage group,only the blastocyst formation rates ( 21. 00%± 22. 02%) was significantly different with normal group ( P <0. 05). Compared with normal group ( 86. 67%),pregnancy rates in higher damage group ( 66. 67%) was significantly lower (χ^2 = 4. 356,P < 0. 05). However,there was no significant difference in abortion rates between the three groups (χ^2 = 0. 078,P > 0. 05). Conclusion: High value of DFI may be associated with lower the good quality embryo rates and blastocyst formation rates,as well as the pregnancy rates, but it is not associated with fertilization rates,cleavage rates and abortion rates.