摘要
目的探讨精子DNA碎片指数(DFI)对行卵胞浆内单精子显微注射(ICSI)技术助孕患者的精液参数、临床和实验室指标、助孕结局的影响。方法回顾性分析2016年1月至2020年12月在广东省第二人民医院生殖医学中心行常规ICSI治疗的患者的336个周期的临床资料。根据DFI水平将所有周期分为三组,A组:DFI≤15%,77个周期;B组:15%<DFI<30%,148个周期;C组:DFI≥30%,111个周期。比较三组的临床基线资料、精液参数与ICSI助孕结局。结果三组女方的体重指数、年龄、基础卵泡刺激素水平、抗苗勒管激素水平,以及男方的禁欲时间、精液体积及精子浓度比较,差异无统计学意义(P>0.05);C组男方年龄显著大于A组和B组(P<0.05);C组精液前向运动精子率(PR)显著低于A组和B组(P<0.05)。DFI与男方年龄呈正相关(P<0.05),与PR呈负相关(P<0.05)。三组正常受精率、卵裂率、优胚率、临床妊娠率比较,差异无统计学意义(P>0.05);C组可利用胚胎率显著低于A组和B组(P<0.05);C组的早期流产率显著高于A组和B组(P<0.05)。结论男性年龄增长和精子DNA损伤的增加可能存在联系,精子DNA损伤与精子前向运动能力减弱可能存在联系;高DFI可降低ICSI治疗的可利用胚胎率,增加早期流产的风险。
Objective To investigate the effects of sperm DNA fragmentation index(DFI)on semen parameters,clinical and laboratory indicators,pregnancy outcome of patients undergoing intracytoplasmic sperm injection(ICSI)assisted pregnancy.Methods A retrospective study of the 336 ICSI cycles in Reproductive Medicine Center of Guangdong Second Provincial General Hospital from January 2016 to December 2020 were conducted.All cycles were divided into three groups based on the DFI levels.Group A:DFI≤15%,77 cycles;Group B:15%<DFI<30%,148 cycles;Group C:DFI≥30%,111 cycles.The clinical baseline data,semen routine parameters and ICSI outcomes of the three groups were compared.Results There was no significant difference in body mass index,age,follicle-stimulating hormone(FSH),anti-Müllerian hormone(AMH)of women,abstinence time,semen volume and sperm concentration of men among the three groups(P>0.05).The age of men in Group C was significantly higher than that in Group A and Group B(P<0.05).Progressive motility(PR)of semen in Group C was significantly lower than that in Group A and Group B(P<0.05).DFI was positively correlated with age(P<0.05),and negatively correlated with PR(P<0.05).There was no significant difference in normal fertilization rate,cleavage rate,good-quality embryo rate and clinical pregnancy rate among the three groups(P>0.05).The available embryo rate of Group C was significantly lower than that of Group A and Group B(P<0.05),and the early abortion rate of Group C was significantly higher than that of Group A and Group B(P<0.05).Conclusions There may be a relationship between the increase of male age and the increase of sperm DNA damage,and there may be a relationship between sperm DNA damage and the decrease of sperm PR.High DFI can reduce the rate of embryos available for ICSI treatment and increase the risk of early abortion.
作者
林子斌
欧湘红
陈雷宁
张琴
李瑾
刘怡潼
谭雯雅
袁瑞莹
李小龙
靖涛
LIN Zibin;OU Xianghong;CHEN Leining;ZHANG Qin;LI Jin;LIU Yitong;TAN Wenya;YUAN Ruiying;LI Xiaolong;JING Tao(Reproductive Medicine Center,Guangdong Second Provincial General Hospital,Guangzhou 518025,Guangdong,China)
出处
《中国性科学》
2022年第3期17-21,共5页
Chinese Journal of Human Sexuality
