精子DNA碎片指数与精液常规参数和生活方式关系及其对夫精人工授精妊娠结局的影响

Relationship of sperm DNA fragments index to semen routine parameters and lifestyle and its effect on the pregnancy outcome of artificial insemination

目的 探讨精子DNA碎片指数(DFI)与男性精液常规参数的关系及其影响因素,以及DFI对夫精宫腔内人工授精(AIH-IUI)妊娠结局的影响.方法 回顾性分析郑州大学第一附属医院生殖中心2017年9月至2018年12月期间AIH-IUI的1185个周期妊娠结局与DFI的关系,比较低DFI组(DFI<15%)和高DFI组(DFI≥15%)的生化、临床妊娠率和早期流产率.同时结合男方生活方式及精液分析参数,分析精子DFI与精液常规参数及男性年龄、体质量指数(BMI)、吸烟、饮酒的关系.结果 低DFI组的AIH-IUI临床妊娠率为16.0%(122/761),高于高DFI组[13.89%(59/424)],但差异无统计学意义(P=0.33);低DFI组IUI的早期流产率[4.1%(5/122)]显著低于高DFI组[15.3%(9/59)](P=0.02);低DFI组的各项精液常规参数指标(精子浓度、活力和正常形态率)均显著高于高DFI组(P均<0.01).相关性分析显示精子DFI与精子浓度、活力及精子正常形态率呈负相关,与男方年龄、禁欲时间及不良的生活方式(吸烟、饮酒)呈正相关.结论 精子DFI增高虽不影响IUI的妊娠率,但与IUI的早期流产风险相关;精子DFI与精液参数有较强相关性,吸烟、饮酒等不良生活方式会导致精子DFI升高.

Objective To explore the effect of sperm DNA fragments index(DFI)on artificial insemination by husband-intrauterine injection(AIH-IUI)pregnancy outcomes,and explore the relationship between sperm DFI and male semen parameters and its influencing factors.Methods The relationship between DFI and 1185 cycles pregnancy outcomes of AIH-IUI in Reproductive Medical Center of the First Affiliated Hospital of Zhengzhou University from September 2017 to December 2018 was retrospectively analyzed,and the pregnancy rate and early abortion rate in low-DFI group(DFI<15%)and high-DFI group(DFI≥15%)were compared.At the same time,the relationship between sperm DFI and male age,body mass index(BMI),smoking,drinking and semen routine parameters was analyzed in combination with male lifestyle and semen analysis parameters.Results IUI clinical pregnancy rate in low-DFI group[16.0%(122/761)]was higher than that in high-DFI group[13.89%(59/424)],but there was no statistical difference(P=0.33).The early abortion rate of low-DFI group[4.1%(5/122)]was significantly lower than that of high-DFI group[15.3%(9/59),P=0.02].Correlation analysis showed that sperm DFI was negatively correlated with sperm concentration,motility and normal sperm morphology rate,while positively correlated with male partner’s age,abstinence time and poor lifestyle(smoking and drinking).Conclusion Sperm DFI is closely related to semen parameters,smoking,drinking and other adverse lifestyle can affect sperm DFI.Although high sperm DFI does not affect the pregnancy rate of IUI,it was associated with the risk of early abortion of IUI.