精子膜及线粒体活性氧对男性生育力的影响及其在辅助生殖技术中的应用

Effects of sperm membrane and mitochondrial reactive oxygen species on male fertility and its application in assisted reproductive technology

目的明确精子活性氧(ROS)对男性生育力的影响及其在辅助生殖中的应用价值,为男性不育患者提供一个新的生育力评估手段及病因治疗方向。方法分析精子膜及线粒体ROS水平与男性不育、精子核DNA完整性及精子膜功能的关系,并分析用于受精的精子膜及线粒体ROS水平与受精率,卵裂率,优胚率及妊娠结局的关系。结果(1)男性不育组精子膜高ROS精子比例显著高于正常生育组(P<0.01),而精子线粒体高ROS精子比例无统计学差异。男性不育组精子ROS异常率显著高于正常生育组,差异具有统计学意义。(2)ROS正常组精子膜功能正常率显著高于ROS异常组(P<0.01),而精子DNA碎片指数(DFI)差异无统计学意义。(3)IVF对照组及IVF观察组受精率差异有统计学意义,而卵裂率、优胚率及临床妊娠率差异无统计学意义。结论精子ROS与男性生育力具有一定关系,ROS异常可导致精子膜功能受损,并可影响精子受精能力,从而影响男性生育功能。精子ROS检测可作为男性生育力评估的一个新手段并可为男性不育的诊疗提供依据。对于助孕及不育患者,可根据精子ROS情况选择合适的受孕时机。

Objective To study the effect of mitochondrial reactive oxygen species(ROS)on male fertility and its application value in assisted reproduction so as to provide a new method for fertility assessment and etiological treatment of male infertility.Methods The relationship between sperm ROS and male infertility,sperm nuclear DNA integrity and sperm membrane function was analyzed.Then the relationships of the ROS of sperms for fertiliza⁃tion with fertilization rate,cleavage rate,embryo rate and pregnancy outcome were analyzed.Results(1)The percentage of the high ROS in sperm membrane of the male infertility group was significantly higher than that of the normal fertility group(P<0.01),but there was no statistical difference in the percentage of the high ROS in the sperm mitochondria between the two groups.(2)The normal rate of sperm membrane function in the normal group was significantly higher than that in the abnormal group(P<0.01),but there was no significant difference in the sperm DNA fragmentation index(DFI)between the groups.(3)There was significant difference in the fertilization rate between the IVF control group and IVF observation group,but no significant difference was seen in the cleavage rate,excellent embryo rate and clinical pregnancy rate between the groups.Conclusion Sperm ROS is related to male fertility to some extent.Abnormal ROS may lead to impaired sperm membrane function and affect sperm fertilization ability,thus affecting male fertility.The detection of ROS in sperm can be used as a new method to evaluate male fertility and provide a basis for diagnosis or treatment of male infertility.For patients with ART or infertility,the appropriate time to conceive can be selected according to the sperm ROS level.