Obesity leads to higher risk of sperm DNA damage in infertile patients

There has been a growing interest over the past few years in the impact of male nutrition on fertility. Infertility has been linked to male overweight or obesity, and conventional semen parameter values seem to be altered in case of high body mass index （BMI）. A few studies assessing the impact of BMI on sperm DNA integrity have been published, but they did not lead to a strong consensus. Our objective was to explore further the relationship between sperm DNA integrity and BMI, through a 3-year multicentre study. Three hundred and thirty male partners in subfertile couples were included. Using the terminal uridine nick-end labelling （TUNEL） assay, we observed an increased rate of sDerm DNA damage in obese men （odds ratio （95% confidence interval）： 2.5 （1.2-5.1））.

Sperm DNA damage in men from infertile couples

Aim： To investigate the prevalence of high levels of sperm DNA damage among men from infertile couples with both normal and abnormal standard semen parameters. Methods： A total of 350 men from infertile couples were assessed. Standard semen analysis and sperm chromatin structure assay （SCSA） were carried out. Results： Ninety-seven men （28% of the whole study group） had a DNA fragmentation index （DFI） 〉 20%, and 43 men （12%） had a DFI 〉 30%. In the group of men with abnormal semen parameters （n = 224）, 35% had a DFI 〉 20%, and 16% had a DFI 〉 30%, whereas these numbers were 15% and 5%, respectively, in the group of men with normal semen parameters （n = 126）. Men with low sperm motility and abnormal morphology had significantly higher odds ratios （ORs） for having a DFI 〉 20% （4.0 for motility and 1.9 for morphology） and DFI 〉 30% （6.2 for motility and 2.8 for morphology） compared with men with normal sperm motility and morphology. Conclusion： In almost one-third of unselected men from infertile couples, the DFI exceeded the level of 20% above which, according to previous studies, the in vivo fertility is reduced. A significant proportion of men with otherwise normal semen parameters also had high sperm DNA damage levels. Thus, the SCSA test could add to explaining causes of infertility in cases where semen analysis has not shown any deviation from the norm. We also recommend running the SCSA test to choose the appropriate assisted reproductive technique （ART）.

Sperm nuclear histone H2B： correlation with sperm DNA denaturation and DNA stainability

Aim： To examine the relationship between sperm DNA damage and sperm nuclear histone （H2B） staining. Methods： We evaluated sperm samples from 14 consecutive asthenoteratozoospermic infertile men and six consecutive fertile controls. Sperm nuclear histone （H2B） staining and sperm chromatin integrity （assessed by sperm chromatin structure assay and expressed using the percentage of （i） DNA fragmentation index [%DFI] and （ii） high DNA stainability [%HDS）]） were evaluated. Results： Histone H2B immunocytochemistry demonstrated two nuclear staining patterns： （i） focal punctate staining; and （ii） diffuse staining. Infertile men had a higher mean percentage of spermatozoa exhibiting diffuse H2B staining than did fertile men （7.7%± 4.6% vs. 1.6% ±1.2%, respectively, P 〈 0.01）. We observed significant relationships between the proportion of spermatozoa with diffuse nuclear histone staining and both sperm %DFI （r = 0.63, P 〈 0.01） and sperm %HDS （r = 0.63, P 〈 0.01）. Conclusion： The data demonstrate that infertile men have a higher proportion of spermatozoa with diffuse histone H2B than do fertile men and suggest that sperm DNA damage might, at least in part, be due to abnormally high histone H2B levels.

Comparison of Three Different Techniques of Human Sperm DNA Isolation for Methylation Assay

Summary： Human sperm DNA is an important genetic and epigenetic material, whose chromatin structure differs from that of somatic cells. As such, conventional methods for DNA extraction of somatic cells may not be suitable for obtaining sperm DNA. In this study, we evaluated and compared three sperm DNA extraction techniques, namely, modified guanidinium thiocyanate method （method A）, traditional phenol-chloroform method （method B）, and TianGen kit method （method C）. Spectrophotometry and agarose gel electrophoresis analyses showed that method A produced DNA with higher quantity and purity than those of methods B and C （P〈0.01）. PCR results revealed that method A was more reliable in amplifying DEAD-box polypeptide 4 （DDX4） and copy number variations （CNVs） than methods B and C, which generated false-positive errors. The results of sperm DNA methylation assay further indicated that methods A and B were effective, and the former yielded higher quantitative accuracy. In conclusion, the modified guanidinium thiocyanate method provided high quality and reli- able results and could be an optimal technique for extracting sperm DNA for methylation assay.

Sperm DNA fragmentation does not affect the clinical outcomes in the cumulative transfers of an ICSI cycle along with blastocyst transfers in couples with normozoospermic male patients

Objective:To know whether sperm DNA fragmentation(SDF)affects the clinical outcomes in the cumulative transfers of an intracytoplasmic sperm injection(ICSI)cycle along with blastocyst transfers in couples with normozoospermic males.Methods:The study included 252 couples who underwent their first ICSI cycles along with blastocyst transfer and whose male partner semen samples were normozoospermic according to the World Health Organization 2010 criteria.All the couples were classified into two groups based on the SDF:the low SDF group(SDF≤30%,n=162)and the high SDF group(SDF>30%,n=90).Clinical as well as laboratory outcomes were correlated between the two groups.Sperm DNA fragmentation was assessed on the post-wash semen samples by acridine orange test.The main outcome measures were the live birth rate and miscarriage rate.Results:A significant decrease in the live birth rates was observed in the high SDF group compared to the low SDF group in fresh embryo transfer cycles(P<0.05).However,no significant difference was observed in the clinical outcomes either in the frozen embryo transfer cycles or in the overall cumulative transfer cycles(P>0.05).No significant difference was observed in the laboratory outcomes between the two SDF groups.A remarkable decrease in sperm motility was observed in the high SDF group compared to the low SDF group(P<0.05).Conclusions:Sperm DNA fragmentation does not affect the clinical outcomes in the cumulative transfers of an ICSI cycle along with blastocyst transfers in couples with normozoospermic males.

Studies of Ce(Ⅲ)-ALC-F Interacting with Herring Sperm DNA by Electrochemical, Fluorimetric and UV-spectrophotometric Method

Ce(Ⅲ)-ALC-F complex can react with hsDNA to form an electrochemically non-active supermolecular complex Ce(Ⅲ)-ALC-F-DNA in the buffer solution of (CH2)6N4(pH=4.9), which results in the decrease of the peak current of Ce(Ⅲ)-ALC-F. This method can be applied to determine DNA concentration. In addition, by using fluorimetric and UV-spectrophotometric methods with studies of denatured DNA and the effect of NaCl solution , it is also found that the binding mode is intercalation.

New approach to assess sperm DNA fragmentation dynamics： Fine-tuning mathematical models

Background： Sperm DNA fragmentation（sDF） has been proved to be an important parameter in order to predict in vitro the potential fertility of a semen sample. Colloid centrifugation could be a suitable technique to select those donkey sperm more resistant to DNA fragmentation after thawing. Previous studies have shown that to elucidate the latent damage of the DNA molecule, sDF should be assessed dynamically, where the rate of fragmentation between treatments indicates how resistant the DNA is to iatrogenic damage. The rate of fragmentation is calculated using the slope of a linear regression equation. However, it has not been studied if s DF dynamics fit this model. The objectives of this study were to evaluate the effect of different after-thawing centrifugation protocols on sperm DNA fragmentation and elucidate the most accurate mathematical model（linear regression, exponential or polynomial） for DNA fragmentation over time in frozen-thawed donkey semen.Results： After submitting post-thaw semen samples to no centrifugation（UDC）, sperm washing（SW） or single layer centrifugation（SLC） protocols, sD F values after 6 h of incubation were significantly lower in SLC samples than in SW or UDC.Coefficient of determination（R-2） values were significantly higher for a second order polynomial model than for linear or exponential. The highest values for acceleration of fragmentation（aSDF） were obtained for SW, fol owed by SLC and UDC.Conclusion： SLC after thawing seems to preserve longer DNA longevity in comparison to UDC and SW. Moreover,the fine-tuning of models has shown that sDF dynamics in frozen-thawed donkey semen fit a second order polynomial model, which implies that fragmentation rate is not constant and fragmentation acceleration must be taken into account to elucidate hidden damage in the DNA molecule.

Inter-center variation in the efficiency of sperm DNA damage reduction following density gradient centrifugation

This was a prospective multicenter study aiming at comparing the efficiency of sperm selection by density gradient centrifugation (DGC) in reducing sperm DNA fragmentation (SDF) in different ART centers. The study was designed using 290 semen samples collected from 10 different ART centers performing artificial insemination, in vitro fertilization and blind assessment of SDF at the University facilities. The results showed that while there was a significant reduction in the SDF levels in sperm isolated from the gradient centrifuged pellet (DGC) compared to neat semen samples (NSS), there was also significant inter-center variability in the efficiency to reduce SDF values by DGC (78.5% to 29.2%). Surprisingly, for some patients, the level of SDF actually increased following sperm selection. The main conclusions derived from this study were that 1) isolation of sperm from the gradient pellet by DGC must be performed using validated, optimized protocols;2) routine comparison of SDF values in NSS semen and in processed sperm after DGC or swim-up must be recommended as part of the internal quality control (QC) of ART laboratories to test the efficacy of sperm processing;and 3) SDF values in processed spermatozoa should be obtained to compare with the pregnancy rate when insemination or fertilization is about to be performed, otherwise, attempts to predict pregnancy outcome from SDF could be biased or are essentially meaningless.

Detection of Sperm DNA Damage in Workers Exposed to Benzene by Modified Single Cell Gel Electrophoresis

Objective To assess the effect of benzene on sperm DNA damage ;Methods Twenty-seven benzene-exposed workers were selected as exposed group and 35 normal sperm donors as control group. Air concentration of benzene series in workshop was determined by gas chromatography. As an internal exposure dose of benzene, the concentration of trans, trans-muconic acid （ttMA） was determined by high performance liquid chromatography. DNA was detected by modified single cell gel electrophoresis （SCGE）. Results The air concentrations of benzene, toluene and xylene at the workplace were 86.49±2.83 mg/m^3, 97.20±3.52 mg/m^3 and 97.45± 2.10 mg/m^3, respectively. Urinary ttMA in exposed group （1.040 ± 0.617 mg/L） was significantly higher than that of control group （0.819 ± 0.157 mg/L）. The percentage of head DNA, determined by modified SCGE method, significantly decreased in the exposed group （n=13, 70.18% ± 7.36%） compared with the control （n=16, 90.62% ± 2.94%）（P〈0.001）. Conclusion The modified SCGE method can be used to investigate the damage of sperm DNA. As genotoxin and reprotoxins, benzene had direct effect on the germ cells during the spermatogenesiss.

Early apoptotic changes in human spermatozoa and their relationships with conventional semen parameters and sperm DNA fragmentation

Aim： To investigate whether early apoptotic changes in spermatozoa can be significant markers for sperm quality. Methods： Two early apoptotic changes in the semen of 56 men were assessed using Annexin V （AN）/propidium iodide （PI） staining for phosphatidylserine externalization and JC-1 staining for mitochondrial membrane potential （MMP）. The results were compared with conventional semen parameters and DNA fragmentation identified using the TUNEL assay. Results： The different labeling patterns in the bivariate Annexin V/PI analysis identified four distinctive spermatozoa populations. The percentage of AN^-/PI^- spermatozoa positively correlated with conventional semen parameters and MMP, but negatively correlated with TUNEL （＋） spermatozoa. As for the AN^-/PI^＋ fraction, we found an opposite result in comparison to AN^-/PI^- spermatozoa. The level of early apoptotic AN^＋/PI^- spermatozoa negatively correlated with MMP and sperm motility. The level of late apoptotic AN^＋/PI^＋ spermatozoa negatively correlated with conventional semen parameters and MMP, and positively correlated with TUNEL （＋） spermatozoa. MMP positively correlated with conventional semen parameters, but negatively correlated with TUNEL （＋） spermatozoa. Conclusion： Although early apoptotic AN^＋/PI^- spermatozoa only negatively correlates with sperm motility, the differences in proportion of each subpopulation of spermatozoa （especially, the percentage of AN^-/PI^- spermatozoa）, and decreased MMP might be significant markers for diagnosing male infertility. They possibly bring additional information to predict the outcome of in vitro fertilization. （Asian J Androl 2008 Mar; 10： 227-235）

Sperm DNA damage and its clinical relevance in assessingreproductive outcome

The routine examination of semen, which assesses sperm concentration, percentage motility and morphology, does not identify subtle defects in sperm chromatin architecture. The focus on the genomic integrity of the male gamete has intensified recently due to the growing concern that genetic diseases may be transmitted via assisted reproductive techniques (ART). Accordingly, the intent of this review is to describe the details of the information pertaining to mitochondrial/nuclear sperm DNA damage with an emphasis on its clinical significance and its relation ship with male infertility. Assessment of sperm DNA damage appears to be a potential tool for evaluating semen samples prior to their use in ART. Testing DNA integrity may help select spermatozoa with intact DNA or with the least amount of DNA damage for use in assisted conception. In turn, this may alleviate the financial, social and emotional problems associated with failed ART attempts.

Correlation between sperm DNA 8-Hydroxy-2'-deoxyguanosine level and semen quality

8-hydroxy-2’-deoxyguanosine (8-OHdG), a typical form ofDNA adducts, is a key molecular biomarker for DNA oxidativedamage. The aim of the present study was to evaluote the correla-tion between the sperm DNA 8-OHdG level and the semen quality.In 52 male infertile patients, the sperm DNA 8-OHdG level wasdetermined by a high performance liquid chromatograph with elec-trochemical detector and the semen quality was examined according

Comparison of four methods to evaluate sperm DNA integrity between mouse caput and cauda epididymidis

It is well known that transit through the epididymis involves an increase in the compaction of sperm chromatin, which acquires fully condensed status at the caput epididymidis. The purpose of this study was to compare the terminal deoxyribonucleotidyl transferase-mediated dUTP nick end-labelling （TUNEL） assay, the comet assay, the sperm chromatin structure assay （SCSA） and the sperm chromatin dispersion （SCD） test by analysing spermatozoa from the caput and cauda epididymidis in order to demonstrate the ability of each technique to discriminate between different degrees of sperm maturity related to chromatin compaction and DNA fragmentation. Our results suggest that some populations of DNA-fragmented spermatozoa associated with immature sperm can only be identified using the comet assay and the SCSA but not with the SCD test or the TUNEL assay.

Effect of sperm DNA fragmentation on assisted reproductive technology treatment category

Objectives:To investigate the effect of sperm DNA fragmentation on outcomes of in vitro fertilization(IVF) and intracytoplasmic sperm injection(ICSI). Methods:A total of 242 cycles(154 IVF and 88 ICSI) from 235 couples were included.Sperm DNA fragmentation(SDF) and routine semen analysis were performed on the retrieval day.The rates of fertilization, embryo cleavage,good quality embryos,implantation and clinical pregnancy were measured. Results:Sperm DNA fragmentation index(DFI) in ICSI group was significantly higher than that in IVF group (P<0.01).The rates of fertilization,implantation and clinical pregnancy in ICSI were significantly higher than those in IVF with DFI≥24%(P<0.05).When DFI exceeded 24%,the OR for clinical pregnancy was 3.85(95% CI 1.40-10.59) comparing ICSI with IVF,and the OR for clinical pregnancy increased to 4.61(95%CI 1.09- 19.57) after inclusion of sperm concentration,progressively motile sperm percentage and female age as covariates. Conclusions:High DNA fragmentation might affect the outcome of ICSI and IVF.When DFI exceeds 24%, ICSI should be chosen instead of IVF.

The relationship between DNA fragmentation and the intensity of morphologically abnormal human spermatozoa

Objective:To determine the relationship between teratozoospermia and sperm DNA fragmentation(SDF)in the human ejaculate.Methods:This retrospective study included 100 normozoospermic men as a control cohort(abnormal forms>14%),210 patients with a high level of abnormal forms(≤4%)and 65 patients presenting with a moderate level of abnormal forms(>4%to≤14%)based on the World Health Organization definitions.Sperm morphology was assessed using bright field microscopy.Sperm DNA fragmentation was assessed using the sperm chromatin dispersion assay.Non-parametric analyses were conducted to examine the relationship between abnormal sperm morphology and sperm DNA fragmentation;receiver operating characteristic(ROC)analyses were conducted to assess sensitivity and specificity of this relationship.Results:A correlation analysis revealed that the higher the proportion of abnormal spermatozoa in the ejaculate,the higher the level of SDF(Spearman's Rho=-0.230;P<0.001).Significant differences in the proportion of SDF were found when all cohorts were compared(P<0.001);these significant differences were also retained when the different cohorts were compared pairwise.ROC analysis showed a moderate but significant predictive value for SDF to differentiate patients with different levels of teratozoospemia.Conclusions:Although analysis of a more continuous range of values for teratozoospermia would help further clarify any causal relationship with SDF,there is clearly a synergistic or coincident affiliation between these variables that needs to be acknowledged by the clinician when interpreting the spermiogram.

时差成像胚胎培养系统观察精子DNA碎片化指数对卵胞浆内单精子显微注射的胚胎发育及临床结局的影响

目的使用时差成像(time-lapse imagining,TLI)胚胎培养系统观察精子DNA碎片化指数(DNA fragmentation index,DFI)对卵胞浆内单精子显微注射(intracytoplasmic sperm injection,ICSI)的胚胎发育指标及临床结局的影响。方法选取2023年1月至6月在上海交通大学医学院附属国际和平妇幼保健院辅助生殖科接受ICSI技术助孕的392对夫妇为研究对象,分为常规培养组284周期和TLI组108周期,再根据DFI≤15%、>15%~<30%、≥30%进一步分为正常组、临界组、异常组。比较各组的临床资料以及临床妊娠结局。统计学方法采用t检验、单因素方差分析、χ^(2)检验或Fisher确切概率法。结果6组的女方年龄、基础促卵泡激素(follicle stimulating hormone,FSH)、身体质量指数(body mass index,BMI)及获卵数比较,差异均无统计学意义(P值均>0.05);男方精液常规指标中,浓度和正常形态率比较,差异均无统计学意义(P值均>0.05);常规正常组、常规临界组、常规异常组、TLI正常组、TLI临界组和TLI异常组的前向运动精子率分别为(46.5±16.5)%、(31.0±14.2)%、(14.8±8.4)%、(41.6±16.2)%、(32.5±14.4)%、(19.3±11.1)%,常规异常组和TLI异常组的前向运动精子率分别低于常规正常组、常规临界组、TLI正常组和TLI临界组(P值均<0.05)。6组的卵裂率和囊胚形成率比较,差异无统计学意义(P>0.05)。常规正常组、常规临界组、常规异常组、TLI正常组、TIL临界组和TLI异常组的受精率分别为(77.3±18.6)%、(78.6±17.1)%、(68.3±22.7)%、(77.4±14.5)%、(74.5±13.1)%、(63.1±25.4)%;常规异常组的受精率低于常规正常组、常规临界组、TLI正常组(P值均<0.05);TLI异常组的受精率低于常规正常组、常规临界组、TLI正常组、TLI临界组(P值均<0.05)。常规正常组、常规临界组、常规异常组的妊娠率分别为57.4%(39/68)、54.5%(24/44)、27.3%(6/22),异常组低于正常组和临界组(P值均<0.05)。TLI正常组、TLI临界组和TLI异常组3组的妊娠率比较,差异无统计学意义(P>0.05)。常规组3组之间以及TLI 3组之间的早期流产率比较,差异无统计学意义(P>0.05)。结论精子DFI值的升高会影响精子前向运动率,还会影响胚胎的受精率,高DFI精子进行ICSI助孕时使用TLI胚胎培养系统可以获得稳定的妊娠率。

中年男性精子DNA碎片率对体外受精-胚胎移植妊娠结局的影响

目的探讨中年男性精子DNA碎片率(DFI)与精液质量和体外受精-胚胎移植妊娠结局的关系。方法共收集180例接受常规体外受精-胚胎移植治疗且男性年龄>38岁的精液标本。根据DFI的阈值分成(<30%和≥30%)两组。主要测量指标包括:常规精液参数、激素水平、DFI、受精率、优质胚胎率、临床妊娠率等。结果通过比较分析发现,DFI与男性卵泡刺激素(FSH)、精子活力、精子形态密切相关,且精子活力随着DFI水平的升高而下降(P<0.05);当DFI≥30%时,优质胚胎率下降(P<0.05),但两组的临床妊娠率差异无显著性(P>0.05)。结论DFI可以作为中年男性精液常规分析的重要参考指标,虽然DFI影响优质胚胎率,但与辅助生殖治疗的临床妊娠结局无关。

精子DNA损伤与精液参数、胚胎发育及复发性流产相关性分析

目的:观察精子DNA损伤与精液参数、胚胎发育及复发性流产(recurrent spontaneous abortion,RSA)的相关性。方法:选择2019年1月—2022年3月佛山市高明区人民医院收治的300例有生育要求的精子DNA损伤患者设为观察组,再选择同期50例精子形态正常(精子正常形态比率≥4%)但配偶为RSA患者的男性设为流产组,50例有生育要求的健康男性设为对照组。比较三组精液参数(精子密度、精子活力、精子形态),根据精子DNA碎片指数将观察组患者分为高损伤组(精子DNA碎片指数≥30%,n=127)和低损伤组(精子DNA碎片指数<30%,n=173),随访比较两亚组患者配偶(自然怀孕和应用辅助生殖技术成功怀孕后)胚胎发育情况及RSA发生情况,分析精子DNA损伤与精子密度、精子活力、精子形态、患者配偶胚胎发育、RSA发生的相关性。结果:三组精液参数比较,差异有统计学意义(P<0.05);观察组精子密度、精子活力、精子形态均低于流产组、对照组,且流产组低于对照组,差异有统计学意义(P<0.05)。高损伤组治疗后自然成功怀孕配偶胚胎发育停滞率、RSA发生率高于低损伤组,差异有统计学意义(P<0.05);高损伤组应用辅助生殖技术成功怀孕胚胎发育停滞率为6.97%,RSA发生率为11.63%。精子DNA碎片指数与精子密度、精子活力、精子形态呈负相关(P<0.05),与患者配偶自然怀孕后胚胎发育停滞、RSA发生呈正相关(P<0.05)。结论:精子DNA损伤与精液参数、胚胎发育及RSA具有一定相关性,精子DNA损伤程度越高,其精液质量越差,自然怀孕后胚胎发育停滞、RSA发生可能性越高,临床可根据患者精子DNA损伤情况,评估不育原因,为临床妊娠选择提供参考依据。

基于活产建立体外受精-胚胎移植精子DNA碎片指数的参考阈值及子代短期安全性

背景:精子DNA碎片指数与受精、胚胎发育潜能、胚胎植入、流产及子代安全性等存在显著的相关性。然而,其临床参考值受多种因素的影响,导致临床意义极其有限,该研究以活产为结局,通过倾向评分匹配校正其他混杂因素后,构建精子DNA碎片指数与活产的最佳临床截断值,并对其进行内外部验证,具有较好的预测价值及临床应用效能。目的:探讨基于活产建立体外受精-胚胎移植精子DNA碎片指数的参考阈值及子代短期安全性。方法:选取2019年5月至2021年5月于常州市妇幼保健院接受体外受精-胚胎移植患者1921例,以倾向匹配容差0.02为标准,1∶1进行倾向评分匹配,结果活产组与非活产组各成功匹配540例,以此建立模型组;通过选取同时期广西壮族自治区南溪山医院接受体外受精-胚胎移植患者135例作为外部验证组;采用受试者工作曲线探求精子DNA碎片指数对活产的临床最佳截断值,分别采用限制性立方样条曲线、标准曲线、临床决策曲线、临床影响曲线及内外部验证等方法,对该截断值的准确性及临床应用效能进行评估。结果与结论:(1)非活产组精子DNA碎片指数显著高于活产组且与活产存在显著的负相关性(r=-0.444,P<0.001);(2)受试者工作曲线结果显示,DNA碎片指数对活产的最佳截断值为24.33%,曲线下面积为0.775(0.746,0.804),特异度为72.60%,敏感度为78.90%,准确度为75.70%;(3)限制性立方样条曲线拟合Logistic回归结果显示,当精子DNA碎片指数大于24.57%时,临床非活产的风险呈趋势性增涨;(4)Logistic回归概率分析结果显示,精子DNA碎片指数为活产的危险因素[OR(95%CI)=0.916(0.904,0.928),P<0.001],且当精子DNA碎片指数大于27.78%时,临床活产发生的概率将小于50%,随着精子DNA碎片指数每增高1个单位,活产的概率下降8.4%;(5)内外部对该临床截断值的验证均显示,该截点具有一定的临床预测价值及准确性;(6)临床决策曲线与临床影响曲线显示,以该临床截断值建立的预测模型在阈概率为0.22-0.73时具有临床最大净获益值,且在该阈概率范围内损失与获益的比值始终小于1,证实该预测模型具有较好的临床应用效能;(7)精子DNA碎片指数与子代短期安全性分析结果显示,精子DNA碎片指数与出生儿早产、体质量、畸形、性别差异无显著性;(8)结果表明,精子DNA碎片指数对体外受精-胚胎移植活产的最佳临床截断值为24.33%,以此建立的临床预测模型具有较好的区分度、准确度与临床应用效能,精子DNA碎片指数对子代短期安全性影响并不显著,但仍需大样本及长期的追踪评估。

精子核DNA完整性测定方案的优化及其在辅助生殖技术中的应用价值

目的:对现有精子核DNA完整性测定方案进行优化,并探讨其在辅助生殖技术(ART)中的应用价值。方法:选择2021年1月1日至2022年12月8日于江西中医药大学附属生殖医院就诊的拟接受体外受精-胚胎移植(IVF-ET)助孕的194对夫妇作为研究对象。采集男方的精液作为对照组(n=194),同一精液经双层密度梯度离心法优化处理后精子混合液作为观察组(n=194)。根据精子核DNA碎片率(DFI)测定结果将对照组及观察组各分为3个亚组,对照A组和观察A组:DFI<15%,对照B组和观察B组:DFI 15%~30%,对照C组和观察C组:DFI≥30%。对观察组与对照组的DFI值及各亚组间的助孕及妊娠情况进行比较。结果:(1)观察组DFI明显低于对照组,差异有统计学意义[(13.55±10.17)%vs.(18.56±11.54)%,P<0.05]。(2)6个亚组间的受精率、卵裂率及优胚率两两比较,差异无统计学意义(P>0.05)。(3)6个亚组的妊娠率和着床率比较,差异有统计学意义(P<0.05);其中,对照A组、对照B组、观察A组、观察B组4组的临床妊娠率(均在65.00%以上)及着床率(均在50.00%)两两比较,差异均无统计学意义(P>0.05),但均高于对照C组(43.24%、31.67%)及观察C组(13.64%、8.82%),差异有统计学意义(P<0.05);对照C组的临床妊娠率及着床率明显高于观察C组,差异有统计学意义(P<0.05)。结论:精液经优化处理后精子核DNA完整性可明显改善。两种不同检测方案在ART中均有较好的应用价值,当精液经优化处理后DFI≥30%时,对ART的不良妊娠结局具有更好的预测价值。