精液优化处理后正常形态精子百分率对体外受精胚胎结局的影响

Influence of the percentage of spermatozoa with normal morphology on in vitro fertilization embryo outcome after optimized semen treatment

目的 分析精液优化处理后正常形态精子百分率对体外受精(IVF)胚胎结局的影响,为临床制定治疗方案提供参考。方法 筛选因女方输卵管因素不孕,且获卵数≥3个的IVF患者255例。按世界卫生组织相关标准对精液优化处理后的精子进行改良巴氏染色,经形态学分析后,以正常形态精子百分率均值为分界点分为A组(正常形态精子百分率≤19.03%)和B组(正常形态精子百分率>19.03%),比较2个组受精率、卵裂率、有效胚胎率、异常受精率和优质胚胎率的差异。结果 A组和B组的受精率分别为77.8%和79.6%,卵裂率分别为95.4%和96.0%,有效胚胎率分别为82.0%和85.4%,异常受精率分别为8.3%和7.7%,优质胚胎率分别为71.4%和71.6%;2个组之间受精率、卵裂率、异常受精率和优质胚胎率差异均无统计学意义(P值分别为0.247、0.461、0.436和0.958);B组有效胚胎率显著高于A组(P=0.038)。结论 精液优化处理后的正常形态精子百分率会影响IVF胚胎结局,建议临床尽早干预,以获得良好的胚胎结局。

Objective To analyze the influence of the percentage of spermatozoa with normal morphology on in vitro fertilization(IVF)embryo outcome after optimized semen treatment,and to provide a reference for clinical treatment. Methods A total of 255 cases of IVF cycles were analyzed in which infertile was caused by women’s fallopian tube disease,and oocytes were obtained ≥3. The semen optimized for IVF treatment was used. According to the related standards of World Health Organization,optimized semen were stained by modified Pap staining method and morphological analysis. According to the percentage of spermatozoa with normal morphology,they were classified into 2 groups,group A ≤19.03% and group B >19.03%. The fertilization rate,cleavage rate,available embryo rate,abnormal fertilization rate and high-quality embryo rate between group A and group B were compared.Results The fertilization rates of group A and group B were 77.8% and 79.6%,the cleavage rates were 95.4% and 96.0%,the available embryo rates were 82.0% and 85.4%,and the abnormal fertilization rates were 8.3% and 7.7%,respectively. The high-quality embryo rates were 71.4% and 71.6%,respectively. There was no statistical significance between the 2 groups in fertilization rate,cleavage rate,abnormal fertilization rate and high-quality embryo rate(P=0.247,0.461,0.436 and 0.958,respectively). The available embryo rate of group B was higher than that of group A(P=0.038). Conclusions The percentage of optimized spermatozoa with normal morphology can affect embryo outcome in IVF cycles. Early intervention is necessary to obtain good embryo outcome.