精子DNA碎片率的影响因素及与常规体外受精早期胚胎发育的关系研究

Analysis of influencing factors of sperm DNA fragmentation index and its relationship with early embryo development during routine in vitro fertilization

目的探讨精子DNA碎片率(DFI)与精液常规参数的相关性及影响因素,研究精子DFI对常规体外受精(IVF)早期胚胎发育的影响。方法选取2022年5月至2023年5月在武汉大学人民医院生殖医学中心就诊的150例男性患者作为研究对象,进行问卷调查,分析精子DFI与精液常规参数、年龄、生活方式及职业的相关性。回顾性分析行IVF治疗的178个周期的临床资料,分析精子DFI及精液常规参数与早期胚胎发育的相关性。结果精子DFI与精子浓度、活力、正常形态率及劳动型职业呈负相关,与年龄及辐射/放射暴露呈正相关(P<0.05)。DFI-B组(15%≤DFI<30%)的受精率为76.39%(64.40%,86.65%),DFI-C组(DFI≥30%)的受精率为67.34%(48.89%,75.00%),均显著低于DFI-A组(DFI<15%)的80.63%(70.26%,90.41%)(P<0.01)。精子DFI与IVF受精率呈显著负相关(P<0.01)。结论精子DFI与精液常规参数存在显著负相关,年龄、辐射/放射暴露会显著负向影响男性精子DFI,体力劳动会显著正向影响男性精子DFI。精子DFI升高可导致IVF受精率降低。

Objective To investigate the correlation and influencing factors between sperm DNA fragmentation index(DFI)and semen routine parameters,and to study the effects of DFI on early embryo development during in vitro fertilization(IVF).Methods A total of 150 male patients admitted to the Reproductive Center of People′s Hospital of Wuhan University from May 2022 to May 2023 were selected as study objects,and investigated by questionnaire.The correlation between sperm DFI and semen routine parameters,male age,lifestyle and occupation was analyzed.The basic information of 178 cycles of IVF treatment were retrospectively analyzed.The correlation of sperm DFI and semen routine parameters with early embryonic development was analyzed.Results Sperm DFI was negatively correlated with sperm concentration,motility,normal morphologic rate and labor occupation,and positively correlated with age and radiation exposure(P<0.05).The fertilization rate of DFI-B group(15%≤DFI<30%)was 76.39%(64.40%,86.65%),and that of DFI-C group(DFI≥30%)was 67.34%(48.89%,75.00%),and they were both significantly lower than those in DFI-A group(DFI<15%)which was 80.63%(70.26%,90.41%)(P<0.01).The sperm DFI was significantly negatively correlated with the fertilization rate of IVF(P<0.01).Conclusions There was a significant negative correlation between sperm DFI and semen routine parameters.Age and radiation exposure had a significant negative impact on male sperm DFI,whereas physical labor had a significant positive impact on male sperm DFI.The increase of sperm DFI could lead to the decrease of IVF fertilization rate.