不同授精方式对高精子DNA碎片指数患者临床结局影响的比较

Effect of different fertilization methods in patients with high Sperm DNA fragmentation index

目的 回顾性分析高精子DNA碎片指数(DFI)患者的临床资料,比较不同的授精方式——体外受精(IVF)和卵母细胞胞质内单精子注射(ICSI)的临床结局,旨在探讨ICSI是否可以改善高精子DNA碎片指数患者的临床结局。方法 选择上海市第一妇婴保健院生殖中心279对体外受精-胚胎移植(IVF-ET)治疗夫妇,其中常规IVF周期138例,ICSI周期141例。比较两组间的正常受精率、可用胚胎率、优质胚率、临床妊娠率、种植率、流产率及出生率等指标。结果 两组的女方年龄、促性腺激素(Gn)注射天数、Gn总量、不育年限、体质量指数、子宫内膜厚度、基础卵泡雌激素值(FSH)和基础血清雌激素值(E2)均无显著性差异。高精子DNA碎片指数IVF组的可用胚胎率显著高于ICSI组(79.3%vs 68.9%,P<0.05)。结论 ICSI技术不能改善高精子DFI患者的临床结局;胚胎质量对妊娠有重要影响。

Objective To investigate whether intracytoplasmic sperm injection(ICSI) can improve the clinical outcomes of the male patients with high Sperm DNA fragmentation index(DFI). Methods We retrospectively analyzed the clinical data of 279 couples undergoing in vitro fertilization-embryo transfer(IVF-ET), including 138 cycles of IVF and 141 cycles of ICSI. We compared the rates of normal fertilization, high-quality embryos, transferrable embryos, clinical pregnancy, implantation, abortion and birth between the two groups. Results There were no statistically significant differences between the two groups in the female age, Gn days, Gn dose, infertility duration, BMI, endometrial thickness, and basal serum FSH and E2.In the high Sperm DNA fragmentation index patients the number of transferrable embryos was significantly higher in the IVF than in the ICSI group(79.3% vs 68.9%, P<0.05). Embryo quality has an important effect on pregnancy. Conclusion ICSI can not improve the clinical outcomes of the male patients with high Sperm DNA fragmentation index.