男性不育症患者AMH与精子DNA碎片率及常规IVF-ET结局的相关性分析

Correlation of anti-Müllerian hormone with sperm DNA fragmentation and the outcomes of routine IVFET in male infertility patients

目的探讨男性不育症患者血清及精浆AMH浓度与精子DNA碎片率的相关性及对常规体外受精-胚胎移植(IVF-ET)结局的影响。方法选取2017年3月至2019年3月就诊于本院生殖中心行IVF助孕的夫妇共105对,检测血清、精浆AMH浓度及精液参数(精液量、精子浓度、前向运动精子百分率、正常形态精子百分比、精子DNA碎片率),分析AMH浓度与精子DNA碎片率的相关性,以及AMH与IVF受精率、优胚率的相关性;比较临床妊娠组及非妊娠组血清及精浆AMH浓度差异性。结果血清及精浆AMH与精子DNA碎片率无线性相关性;精浆AMH与2PN受精率(R 2=0.051,P=0.02)、D3优胚率(R 2=0.056,P=0.01)呈正相关;血清AMH与2PN受精率(R 2=0.003,P=0.59)、D3优胚率(R 2=0.004,P=0.52)无线性相关性;临床妊娠组精浆AMH(13.63±5.51),非妊娠组(14.68±4.05),差异无统计学意义(P>0.05);临床妊娠组血清AMH(9.70±4.92),非妊娠组(9.43±4.69),差异无统计学意义(P>0.05)。结论精浆AMH可作为预测男性不育症患者2PN受精率及D3优胚率的实验室指标;但血清及精浆AMH对临床妊娠率无预测价值。

Objective To assess the correlation between AMH concentration and sperm DNA fragmentation and the outcomes of routine in vitro fertilization-embryo transfer(IVF-ET)in male infertility patients.Methods We collected the data,including AMH in seminal plasma and serum AMH and semen quality,including semen volume,sperm concentration,progressive sperm motility,morphologically normal sperm,and sperm DNA fragments,from 105 infertile males undergoing IVF from March,2017 to March,2019.We analyzed the correlation of AMH concentration with sperm DNA fragmentation,the fertilization rate,and high quality embryo rate.We compared the differences in serum and seminal plasma AMH between the clinical pregnancy group and the non-pregnancy group.Results There was no linear correlation between the AMH and the sperm DNA fragmentation.The concentration of AMH in seminal plasma was positively correlated with the 2PN fertilization rate(R2=0.051,P=0.02)and the D3 high quality embryo rate(R2=0.056,P=0.01).In addition,AMH in serum had no significant correlation with the 2PN fertilization rate(R2=0.003,P=0.59)and the D3 high quality embryo rate(R2=0.004,P=0.52).There was no statistical difference in seminal plasma AMH between the clinical pregnancy group and the non-pregnancy group[(13.63±5.51)vs.(14.68±4.05);P>0.05].There was no statistical difference in serum AMH between the clinical pregnancy group and the non-pregnancy group[(9.70±4.92)vs.(9.43±4.69);P>0.05].Conclusion AMH in seminal plasma can be used as a laboratory indicator to predict 2PN fertilization rate and D3 high quality embryo rate in male infertility patients.However,AMH has no predictive value for clinical pregnancy rate both in serum and seminal plasma.