Y染色体AZFc区部分缺失对无精子症和严重少精子症患者ICSI结局的影响

The effect of partial deletions in the azoospermia factor C subregion of the Y chromosome on reproductive outcomes of ICSI among azoospermia and severe oligozoospermia patients

目的 探讨Y染色体无精子因子(AZF)c区部分缺失对无精子症和严重少精子症患者的助孕妊娠结局的影响。方法 回顾性分析2012年1月至2023年10月期间联勤保障部队第九○○医院生殖医学中心收治的80例无精子症和严重少精子症患者的助孕临床资料,根据AZFc区是否存在缺失分为缺失组(存在AZFc区部分缺失,n=34)和对照组(未见缺失,n=46),再根据缺失类型,将缺失组分为gr/gr缺失亚组(n=22)和b2/b3缺失亚组(n=12),比较分析各组的胚胎发育情况及临床妊娠结局。结果 整体缺失组的正常受精率显著低于对照组(60.61%vs.74.44%,P<0.01),而2PN卵裂率、优质胚胎率、HCG阳性率和临床妊娠率在两组间均无显著性差异(均P>0.05)。缺失组中的亚组与对照组相比,gr/gr缺失亚组和b2/b3缺失亚组的正常受精率均显著下降(63.75%、54.47%vs.74.44%,P<0.05),而2PN卵裂率和优质胚胎率的差异无统计学意义(P>0.05);两个缺失亚组间的受精和胚胎发育情况的差异均无统计学意义(P>0.05)。结论 AZFc区的gr/gr缺失与b2/b3缺失虽影响无精子症和严重少精子症患者ICSI过程中的正常受精率,但对ICSI的临床妊娠结局无明显影响。

Objective:To investigate the effect of partial deletions in the azoospermia factor c subregion(AZFc)of the Y chromosome on reproductive outcomes of ICSI among azoospermia and severe oligozoospermia patients.Methods:Clinical data of men suffering from azoospermia and severe oligozoospermia at Reproductive Center of the 900 th Hospital from January 2012 to October 2023 were retrospectively analyzed.The patients were divided into a deletion group(partial deletion of AZFc region,n=34)and a control group(no deletion seen,n=46)according to the presence or absence of deletion of the AZFc region.The deletion group was then categorized into gr/gr deletion subgroups(n=22)and b2/b3 deletion subgroups(n=12)based on the deletion type.Embryonic development and clinical pregnancy outcomes were compared and analyzed among the groups.Results:The normal fertilization rate in the deletion group was significantly lower than that in the control group(60.61%vs.74.44%,P<0.01),but there were no significant differences in bipronuclear(2PN)cleavage rate,high-quality embryo rate,positive rate of HCG and clinical pregnancy rate(P>0.05).Subgroups in the deletion group had significantly lower normal fertilization rates in both the gr/gr deletion subgroup and the b2/b3 deletion subgroup compared with the control group[63.75%,54.47%vs.74.44%,P<0.05],while the differences in 2PN cleavage rate and the rate of high-quality embryos were not statistically significant(P>0.05).And there were no significant differences in fertilization and embryo development between the two deletion subgroups(P>0.05).Conclusions:During ICSI for azoospermia and severe oligozoospermia,AZFc gr/gr deletion and AZFc b2/b3 deletion could affect normal fertilization rate but not the clinical outcomes of ICSI.