摘要
目的:分析行IVF/ICSI男性患者染色体多态性发生情况及其对精液质量和精子DNA完整性的影响。方法:回顾性分析2016年6月至2018年6月2 370例行IVF/ICSI男性患者染色体核型,统计染色体多态性类型、发生率及占比;根据相应的纳排标准,最终纳入研究对象2 206例,其中染色体多态性患者146例,按照染色体核型将研究对象分为4组(A组:常染色体长臂次缢痕改变;B组:D/G组染色体短臂多态;C组:9号染色体臂间倒位;D组:Y染色体多态),比较4组染色体多态性患者与染色体正常患者的精液质量与精子DNA碎片指数(DFI)的差异。结果:①IVF/ICSI男性患者中,染色体多态性154例,总发生率6.50%;其中常染色体长臂次缢痕改变34例,发生率1.43%,占比22.08%;D/G组染色体短臂多态82例,发生率3.46%,占比53.25%;9号染色体臂间倒位26例,发生率1.10%,占比16.88%;Y染色体多态10例,发生率0.42%,占比6.50%;混合多态2例,发生率0.08%,占比1.42%。②D组精子总数低于正常组和其他多态性组,但各组间差异无统计学意义(P>0.05)。D组前向运动精子百分率(PR%)低于正常组和其他多态性组,D组与B组之间差异有统计学意义[(27.5±13.5)%vs(41.5±21.1)%,P=0.027)],其他各组间差异无统计学意义(P>0.05)。各多态性组精子DFI与正常组相比差异均无统计学意义(P>0.05),各多态性组之间相比差异也均无统计学意义(P>0.05)。③D组正常精液比例低于正常组和其他多态性组,但各组间差异无统计学意义(P>0.05)。D组弱精子症比例高于正常组和其他多态性组,但各组间差异无统计学意义(P>0.05)。D组少弱精子症比例高于正常组和其他多态性组,D组与正常组之间差异有统计学意义(30.0%vs 8.0%,P=0.041),其他各组间差异无统计学意义(P>0.05)。结论:D/G组染色体短臂多态是IVF/ICSI男性患者中最常见的染色体多态性类型,Y染色体多态对精液质量存在一定的负面影响,而其他类型染色体多
Objective: To investigate the incidence of chromosome polymorphisms and their influence on semen quality and sperm DNA integrity in male patients receiving in vitro fertilization/intracytoplasmic sperm injection(IVF/ICSI). Methods: We retrospectively analyzed the chromosomal karyotypes and the types and incidence rate of chromosome polymorphisms in 2 370 male patients undergoing IVF/ICSI between June 2016 and June 2018. We classified the patients into groups A(with variation in the secondary constriction region in the autosomal long arm), B(with variation in the short arm of the D/G group chromosomes), C(with interbrachial inversion of chromosome 9) and D(with Y chromosome polymorphisms), and compared the semen parameters and sperm DNA fragmentation indexes(DFI) between the patients with chromosome polymorphisms and those with normal chromosomes. Results: Totally, 154(6.50%) of the patients undergoing IVF/ICSI were found with chromosome polymorphisms, including 34 cases of secondary constriction variation in the long arm of the autosome(1.43%[34/2 370], 22.08%[34/154]), 82 cases of short arm polymorphisms of the D/G group chromosomes(3.46%[82/2 370], 53.25%[82/154]), 26 cases of interbrachial inversion of chromosome 9(1.10%[26/2 370], 16.88%[26/154]), 10 cases of Y chromosome polymorphisms(0.42%[10/2 370], 6.50%[10/154]), and 2 cases of mixed chromosome polymorphisms(0.08%[2/2 370], 1.42%[2/154]). The total sperm count was lower in group D than in the other polymorphism groups and the normal chromosome group, but with no statistically significant difference among the five groups(P > 0.05). The sperm progressive motility was also lower in group D than in the other five groups, with statistically significant difference from group B(27.5 ± 13.5 vs. 41.5 ± 21.1, P = 0.027), but not from the other groups(P > 0.05). No statistically significant difference was observed in the sperm DFI between the polymorphism groups and the normal chromosome group(P > 0.05), or among the polymorphism groups(P > 0.05). The proportion
作者
毛献宝
薛林涛
莫伟英
莫耀禧
成俊萍
王世凯
黄悦悦
李政达
张小慧
周亭亭
韦娉嫔
谭卫红
MAO Xian-bao;XUE Lin-tao;MO Wei-ying;MO Yao-xi;CHENG Jun-ping;WANG Shi-kai;HUANG Yue-yue;LI Zheng-da;ZHANG Xiao-hui;ZHOU Ting-ting;WEI Ping-pin;TAN Wei-hong(Center of Reproductive Medicine and Genetics, People’s Hospital of Guangxi Zhuang Autonomous Region , Nanning, Guangxi 530021 , China)
出处
《中华男科学杂志》
CAS
CSCD
北大核心
2019年第3期223-230,共8页
National Journal of Andrology
基金
国家自然科学基金(81360107)
广西卫生和计划生育委员会科研课题(Z20180742)~~
