计算机辅助分析精子运动能力在试管婴儿术中的应用

The Application of Computer Assisted Sperm Analysis on in vitro Fertilization

目的 用计算机辅助分析方法 (CASA)评价精子的运动能力 ,并探讨各参数与试管婴儿术成功率的关系 ,从男性方面确立临床上用于试管婴儿术预后的定量参数。方法 根据卵的受精情况分为受精率≥ 5 0 %组、受精率 <5 0 %组和受精率为 0三组 ;根据胚胎移植后妊娠情况分为妊娠组和非妊娠组 ,以代表试管婴儿术成功率的高低。对与精子运动有关的参数进行定量测定 ,用 t检验法确定与试管婴儿术的成功率高低有关的参数。结果 本试验共进行了 6 9个周期 ,实际完成了 6 4个 ,妊娠 2 0例 (包括生化妊娠和临床妊娠 )。体外受精率≥ 5 0 %组的精子活力、VAP、VSL 和 VCL 值四项精子运动参数以及正常形态精子百分比与体外受精率 <5 0 %组和体外受精率为 0组比较有高度显著性差异 (P<0 .0 1) ;妊娠组与非妊娠组上述各项参数的比较也有高度显著性差异 (P<0 .0 1) ,并且洗涤后的精子运动参数和正常形态精子百分比较洗涤前有显著提高 (P<0 .0 5 )。结论 试管婴儿术的成功率与精子的运动能力有关 ,定量参数 VAP、VSL、VCL 值和正常形态精子百分比可用于试管婴儿术的临床预后判断 ,精子的洗涤处理会改善精子的运动参数 。

Objective To set up the prognostic parameters for clinical use of IVF ET technique from the male side, the influence of the quantitative parameters about sperm motility on human in vitro fertilization rate was evaluated in this study. Methods The sperm samples were classfied into three groups in accordance to the eggs' in vitro fertilization rate of ≥50%, <50% and zero. Besides,based on the achievement of pregnancy after embryo transfer, the samples were divided into two groups: pregnancy achieved and pregnancy not achieved. Then we adopted the system of computer assisted sperm analysis (CASA) in assessing some parameters about sperm movement. The correlation between them and IVF rate or pregnancy was analyzed with t test. Results This study embraced 69 IVF cycles, among which 64 cycles were completed with 20 cases of pregnancy, including biochemical and clinical pregnancies. The data on sperm movement parameters showed significant difference in Progressive motility, VAP, VSL, VCL and Percent normal sperm morphology between the ≥50% group and the <50% and zero groups ( P <0.01). Significant difference in the above parameters was also observed between the pregnancy positive and negative groups( P <0.01). Besides, there were significant differences in Sperm movement parameters and Percent normal morphology between pre and post washed grops ( P <0.05). Conclusion This study has demonstrated that the success rate of 'test tube baby' is tightly related to some sperm movement parameters, thus suggesting VAP, VSL and VCL can serve as prognostic parameters for clinical application of IVF.