摘要
目的：探讨优选后精子DNA完整性对体外受精-胚胎移植（IVF-ET）中胚胎发育及临床结局的影响。方法：选取2013年1月1日至2014年12月31日因单纯输卵管性不孕行常规IVF的605个周期的临床资料。取卵日,将授精剩余精子采用精子染色质扩散（SCD）实验检测DNA碎片。采用受试者工作特征（ROC）曲线和约登指数,根据优选后DNA碎片指数（DFI）预测IVF种植失败（种植率=0%）、早期流产、受精失败（受精率〈25%）的阈值进行分组,分析DFI与IVF结局的相关性。结果：根据所得DFI相应阈值分为〈5%、（5~10）%、（10~15）%、≥15%4组。受精率、卵裂率、优质胚胎率、种植率、临床妊娠率、早期流产率、活产率各组差异有统计学意义（P均〈0.05）,多胎妊娠率、早产率、低出生体重率各组差异无统计学意义（P均〉0.05）。DFI与受精率、卵裂率、优质胚胎率、临床妊娠率、活产率均呈负相关,r分别为-0.32、-0.19、-0.40、-0.20、-0.09,P分别为〈0.01、〈0.01、〈0.01、〈0.01、0.04;与早期流产率呈正相关（r=0.23,P〈0.01）;与多胎妊娠率、早产率、低出生体重率无显著相关性,r分别为-0.01、0.04、0.03,P分别为0.83、0.54、0.62。结论：优选后精子DNA完整性影响IVF受精、胚胎发育、早期流产和活产结局,与早产和低出生体重的相关性尚需深入研究。
Objective： To investigate the influence of the DNA integrity of optimized sperm on the embryonic development and clinical outcomes of in vitro fertilization and embryo transfer（ IVF-ET）. Methods： This study included 605 cycles of conventional IVF-ET for pure oviductal infertility performed from January 1,2013 to December 31,2014. On the day of retrieval,we examined the DNA integrity of the sperm using the sperm chromatin dispersion method. According to the ROC curve and Youden index,we grouped the cycles based on the sperm DNA fragmentation index（ DFI） threshold value for predicting implantation failure,early miscarriage,and fertilization failure,followed by analysis of the correlation between DFI and the outcomes of IVF-ET. Results： According to the DFI threshold values obtained,the 605 cycles fell into four groups（ DFI value 5%,5- 10%,10- 15%,and ≥15%）. Statistically significant differences were observed among the four groups in the rates of fertilization,cleavage,high-quality embryo,implantation,clinical pregnancy,early miscarriage,and live birth（ P〈0. 05）,but not in the rates of multiple pregnancy,premature birth,and low birth weight（ P〈0. 05）. DFI was found to be correlated negatively with the rates of fertilization（ r =- 0. 32,P〈0. 01）,cleavage（ r =- 0. 19,P〈0. 01）,high-quality embryo（ r =- 0. 40,P〈0. 01）,clinical pregnancy（ r =- 0. 20,P〈0. 01）,and live birth（ r =- 0. 09,P = 0. 04）,positively with the rate of early miscarriage（ r = 0. 23,P〈0. 01）,but not with the rates of multiple pregnancy（ r =- 0. 01,P = 0. 83）,premature birth（ r = 0. 04,P = 0. 54）,and low birth weight（ r = 0. 03,P = 0. 62）. Conclusion：The DNA integrity of optimized sperm influences fertilization,embryonic development,early miscarriage,and live birth of IVF-ET,but its correlation with premature birth and low birth weight has to be further studied.
出处
《中华男科学杂志》
CAS
CSCD
北大核心
2016年第5期425-431,共7页
National Journal of Andrology
基金
国家自然科学基金(81370760)~~
关键词
精子DNA完整性
DNA碎片指数
体外受精-胚胎移植
胚胎发育
妊娠结局
sperm DNA integrity
DNA fragmentation index
in vitro fertilization and embryo transfer
embryonic development
pregnancy outcome
