关于男性年龄对体外受精结局的影响研究

Study on the effect of male age on in vitro fertilization outcome

目的探讨男性年龄对常规体外受精(IVF)结局的影响。方法选取2015年5月至2018年3月邯郸市中心医院生殖医学科行体外受精(IVF)的208例患者作为研究对象。筛选输卵管梗阻因素且男性精液常规均正常的不孕患者208例,按男性年龄分为≤30岁组(n=116)、31岁~35岁组(n=64)和≥36岁组(n=28)共三组,比较各组的精液体积、精子浓度、前向运动精子比率、精子正常形态比率、DNA碎片率及IVF受精率、卵裂率、优胚率、可利用胚胎率、囊胚形成率、妊娠率、流产率等。结果研究发现≥36岁组前向运动精子比率低于≤30岁组,DNA碎片率高于≤30岁组和31岁~35岁组,囊胚形成率显著低于≤30岁组,流产率高于≤30岁组,差异具有统计学意义(P<0.05),而各组其余精液参数及IVF各项指标相比差异均无统计学意义(均P>0.05)。结论男性年龄与受精率、卵裂率、优胚率、可利用胚胎率、妊娠率均无明显相关性,但随男性年龄增加,前向运动精子比率及囊胚形成率下降,DNA碎片率及流产率升高。

Objective To investigate the effect of male age on conventional in vitro fertilization(IVF) outcomes. Methods A retrospective analysis of 208 infertile patients received IVF in the Reproductive Medicine Center of Handan Central Hospital from May 2015 to March 2018 was performed. The 208 male patients with normal semen routine and tubal obstruction were divided into three groups according to their ages, i.e. ≤ 30-year-old group(n=116), 31~35 years old group(n=64) and ≥36 years old group(n=28). The semen volume, sperm concentration, forward movement sperm ratio, normal sperm morphology ratio, DNA fragmentation rate and IVF fertilization rate, cleavage rate, excellent embryo rate, available embryo rate, blastocyst formation rate, pregnancy rate and abortion rate were compared between groups. Results The ratio of forward movement sperm in the ≥36 years old group was lower than that in the ≤30 group, the DNA fragment rate was higher than that in the ≤30 group and 31~35 years old group, the blastocyst formation rate was significantly lower than that in the ≤30 group, and the abortion rate was higher than that in the ≤30 group, with statistically significant differences(P<0.05), but there was no statistically significant difference in the other semen parameters and IVF indexes between groups(all P>0.05). Conclusions There is no significant correlation between male age and fertilization rate, cleavage rate, excellent embryo rate, available embryo rate and pregnancy rate, but with the increase of male age, the ratio of forward movement sperm and blastocyst formation decreases while DNA fragmentation rate and the rate of abortion increases.