精子DNA损伤对体外受精-胚胎移植妊娠结局的影响研究

Study on the effect of sperm DNA damage on pregnancy outcome of in vitro fertilization-embryo transfer

目的 分析精子DNA损伤与体外受精-胚胎移植(IVF-ET)受精率、胚胎发育及妊娠结局等的关系。方法 选取2020年1月至2021年8月甘肃省妇幼保健院诊治的286例不孕不育患者作为研究对象,经双方病因筛查,确定需进行IVF-ET。对其进行常规精液分析及形态评估,采用精子染色质结构分析法(SCSA)计算精子DNA碎片指数(DFI),根据精子DFI将其分为A组(DFI≤15%,n=72)、B组(15%30%,n=76)。统计分析三组体外受精(IVF)率、卵裂率、优质胚胎率、种植率和妊娠结局。结果 三组间正常受精率及总受精率比较,A组高于B组及C组,差异具有统计学意义(P<0.05);B组与C组比较,差异无统计学意义(P>0.05)。三组间卵裂率比较,差异无统计学意义(P>0.05)。三组间优质胚胎率比较,A组高于B组及C组,差异具有统计学意义(P<0.05);B组与C组比较,差异无统计学意义(P>0.05)。三组间种植率比较,C组低于B组,差异具有统计学意义(P<0.05);C组与A组比较,差异无统计学意义(P>0.05)。三组间妊娠率比较,B组与A组、B组与C组、C组与A组比较,差异具有统计学意义(P<0.05)。三组间流产率比较,差异无统计学意义(P>0.05)。结论 精子DFI可用于评估部分精液质量指标,将精子DFI检测作为常规检测,可以更全面地评估男性精液质量。精子DNA损伤会对IVF率、种植率、优质胚胎率和妊娠结局产生不良影响。

Objective To analyze the relationship between sperm DNA damage and fertilization rate, embryo development and pregnancy outcome of in vitro fertilization-embryo transfer(IVF-ET). Methods A total of 286 infertility patients treated in Gansu Provincial Maternal and Children Health Care Hospital from January 2020 to August 2021 were selected as the research objects.After being screened for etiology on both sides, they were identified as requiring IVF-ET.Routine semen analysis and morphological assessment were performed, and sperm DNA fragmentation index(DFI) was calculated by sperm chromatin structure assay(SCSA).According to sperm DFI, the objects were divided into group A(DFI ≤15%, n=72), group B(15%30%, n=76);the in vitro fertilization(IVF) rates, egg cleavage rates, quality embryo rates, embryo implantation rates and pregnancy outcome were statistically analyzed.Results The normal and total fertilization rates compared among the three groups, group A was higher than group B and group C, with statistically significant difference(P<0.05), but the difference between group B and group C was not statistically significant(P>0.05).Comparing the egg cleavage rates, among the three groups, the differences were not statistically significant(P>0.05).As for the quality embryo rates among the three groups, group A was higher than groups B and group C, with statistically significant difference(P<0.05), but the difference between group B and group C was not statistically significant(P>0.05).As for the embryo implantation rate among the three groups, group C was lower than group B, with a statistically significant difference(P<0.05), but the difference between group C and group A was not statistically significant(P>0.05). Regarding the pregnancy rates among the three groups, the difference was statistically significant between group B and group A, group B and group C, group C and group A(P<0.05).There was no significant difference in the abortion rates among the three groups(P>0.05). Conclusions Sperm DFI can be used to assess some of the semen quality indicators, and including it into routine test can provide a more comprehensive assessment of male semen quality.Sperm DNA damage can adversely affect IVF rates, embryo implantation rates, quality embryo rates and pregnancy outcome.