精子染色质扩散实验中精子晕环类型与体外受精/卵胞浆内单精子注射治疗结局相关性研究

Relationship between the sperm halo types in sperm chromatin dispersion test and the outcome of IVF/ICSI treatment

目的探讨精子染色质扩散(SCD)实验中精子晕环类型与体外受精(IVF)/卵胞浆内单精子注射(ICSI)治疗结局的相关性。方法收集2017年7月至2019年7月于南方医科大学南方医院生殖医学中心进行IVF/ICSI治疗且男方接受了精液常规分析及SCD实验的184对夫妇的IVF/ICSI治疗相关数据。依据SCD结果中各类型晕环精子百分比及精子DNA碎片指数(DFI)的第25百分位数(P_(25))及第75百分位数(P_(75))的具体数值,将各晕环精子百分比及DFI各自分为3组:A组(≤P_(25))、B组(P_(25)~P_(75))、C组(≥P_(75))。采用非参数检验比较各组间受精率、卵裂率、优胚率、临床妊娠率及流产率。结果退化精子百分比A组、B组、C组患者的优胚率分别为(33.1±22.9)%、(31.6±23.6)%、(21.3±20.9)%,3组间比较差异有统计学意义(P=0.046)。小晕环精子百分比A组、B组、C组患者的流产率分别为22.2%、33.3%、83.3%,3组间比较差异有统计学意义(P=0.024)。各晕环精子百分比及DFI的不同亚组间受精率、卵裂率、临床妊娠率差异均无统计学意义(P>0.05)。结论退化精子百分比可能是预测胚胎质量更为敏感的指标,高小晕环精子百分比可能增加流产风险。

Objective To explore the relationship between the sperm halo types in sperm chromatin dispersion(SCD)test and the outcome of IVF/ICSI treatment.Methods The clinical data of 184 infertile couples who received IVF/ICSI treatment in the reproductive center of Nanfang Hospital from July 2017 to July 2019 were collected.The routine semen analysis and SCD test were performed.The effect of SCD experiment results on IVF/ICSI treatment outcome were observed.According to the specific values of the 25^(th) and 75^(th) percentiles of each type of halo sperm percentage and total sperm DNA fragmentation index(DFI)in the SCD results,all subjects were divided into three groups:Group A(≤25^(th) percentile);Group B(25^(th)-75^(th) percentile);Group C(≥75^(th) percentile).Nonparametric tests were adopted to compare the fertilization rate,cleavage rate,good embryo rate,clinical pregnancy rate and abortion rate among these three groups.Results The good embryo rate in group A,group B,and group C of degenerative sperm were(33.1±22.9)%,(31.6±23.6)%and(21.3±20.9)%,and the difference was statistically significant(P=0.046).The abortion rate in group A,group B,and group C of small halo sperm were 22.2%,33.3%and 83.3%,and the difference was statistically significant(P=0.024).However,there were no significant differences in fertilization rate,cleavage rate,or clinical pregnancy rate between every subgroup of each type of halo sperm percentage,degenerated sperm percentage,and DFI(P>0.05).Conclusion The percentage of degenerative sperm may be a more sensitive indicator for embryo quality,and the higher percentage of small halo sperm may increase the risk of miscarriage.