精子DNA完整性与辅助生殖结局关系的Meta分析

A Meta-analysis of correlation of sperm DNA integrity with assisted reproduction outcomes

目的综合分析精子DNA碎片化程度对体外受精(in vitro fertilization,IVF)、卵胞浆内单精子注射(intracytoplasmic sperm injection,ICSI)治疗结果的影响,为提高辅助生殖的临床成功率提供参考依据。方法检索Pub Med、CNKI等相关中英文数据库,筛选纳入精子DNA碎片指数(DNA fragmentation index,DFI)对IVF、ICSI临床结局影响的文献,采用Stata 12.0软件对提取的数据进行分析,报告危险因素的合并相对危险系数RR(95%CI)值。结果本研究最终纳入15篇有效文献,合并RR(95%CI)值分别为:ICSI临床妊娠率0.84(0.63~1.13)在高DFI组与低DFI组之间的差异均无统计学意义(均有P>0.05),IVF临床妊娠率0.79(0.67~0.94)、IVF流产率1.69(1.03~2.78)、ICSI流产率2.07(1.22~3.50),除ICSI临床妊娠率以外,各指标差异均有统计学意义(均有P<0.05)。结论精子DNA的完整性影响IVF、ICSI治疗结果 。

Objective To investigate the effect of sperm DNA fragmentation index on treatment outcomes of in vitro fertilization( IVF) and intracytoplasmic sperm injection( ICSI),and to provide a reference for improving the clinical success of assisted reproduction. Methods Database in both English and Chinese,Such as Pub Med,CNKI,etc were retrieved. The literatures about the sperm DNA fragmentation index( DFI) affecting IVF and ICSI clinical outcomes were screened. Stata12. 0 software was used to analyze the extracted data,and then merged RR values of risk factors and their 95% CI were reported. Results In the included 15 valid documents,the merged RR values and their 95% CI were as follows: 0. 84( 0. 63-1. 13) of ICSI clinical pregnancy rate was found,between high DFI group and low DFI group,with no statistically significant differences( all P > 0. 05); IVF clinical pregnancy rate was 0. 79( 0. 67-0. 94),IVF miscarriage rate was 1. 69( 1. 03-2. 78),and ICSI miscarriage rate was 2. 07( 1. 22-3. 50). In addition to the clinical pregnancy rate of ICSI,all of those factors were statistically significant( all P < 0. 05). Conclusions Sperm DNA integrity affects the treatment outcomes of IVF and ICSI.