摘要
目的探讨精子顶体酶活性对体外受精(IVF)实验室结局的影响。方法回顾性分析2020年6月至2022年12月河北生殖妇产医院诊治的1729对接受IVF夫妇的实验室结局。先根据IVF受精率分为A组(n=61,受精率≤35%)、B组(n=105,35%<受精率<65%)和C组(n=1563,受精率≥65%),比较三组的精子顶体酶活性、正常形态精子百分率和精子DNA碎片指数等。再根据精子顶体酶活性分为D组(n=80,精子顶体酶活性≤30.0μIU/10^(6))、E组(n=331,精子顶体酶活性>30.0~<48.2μIU/10^(6))和F组(n=1318,精子顶体酶活性≥48.2μIU/10^(6)),比较三组的受精率、补救率、优质胚胎率、囊胚形成率等。结果A组、B组的精子顶体酶活性显著低于C组(P<0.05)。D组、E组、F组受精率呈升高趋势,补救率呈下降趋势,三组间比较差异具有统计学意义(P<0.05);但三组间优质胚胎率、囊胚形成率比较,差异无统计学意义(P>0.05)。受试者工作特征(ROC)曲线结果显示,精子顶体酶活性预测补救率的曲线下面积(AUC)为0.642(P<0.05),临界值为48.29μIU/10^(6)。结论精子顶体酶活性对IVF受精率有显著影响,精子顶体酶活性低的患者受精率显著下降、补救率显著升高。建议低精子顶体酶活性的患者行部分卵胞质内单精子注射(Half-ICSI)受精,或可优化实验室受精结局。
Objective To explore the impact of sperm acrosome enzyme activity on laboratory outcomes of in vitro fertilization(IVF).Methods A retrospective analysis was conducted on the laboratory outcomes of 1,729 pairs of couples who underwent IVF at Hebei Maternity Hospital from June 2020 to December 2022.Firstly,based on the fertilization rates(FR)of IVF,the patients were divided into group A(n=61,FR≤35%),group B(n=105,35%<FR<65%),and group C(n=1,563,FR≥65%);the sperm acrosome enzyme activity,normal sperm morphology rate,and sperm DNA fragmentation rate were compared among the three groups.Then,according to the activity of sperm acrosome enzymes,the patients were divided into group D(n=80,acrosomal enzyme≤30.0μIU/10^(6)),group E(n=331,acrosomal enzyme>30.0~<48.2μIU/10^(6)),and group F(n=1,318,acrosomal enzyme≥48.2μIU/10^(6));the laboratory outcomes such as fertilization rate,salvage rate,high-quality embryo rate,and blastocyst formation rate of the three groups were compared.Results The sperm acrosomal enzyme activity in group A and group B were significantly lower than that in group C(P<0.05).The fertilization rate of group D,group E and group F showed an increasing trend,while the salvage rate showed a decreasing trend,there was a statistically significant difference in the comparison among the three groups(P<0.05);however,there was no significant difference in comparing the rates of high-quality embryos and blastocyst formation among the three groups(P>0.05).The results of receiver operating characteristic(ROC)curve showed that the area under the curve(AUC)for predicting salvage rate by sperm acrosome enzyme activity was 0.642(P<0.05),and the critical value was 48.29μIU/10^(6).Conclusions Sperm acrosomal enzyme activity has a significant impact on IVF fertilization rate.Patients with low sperm acrosomal enzyme activity have a significantly decreased fertilization rate and a significantly increased salvage rate.It is recommended that patients with low sperm acrosomal enzyme activity undergo half intracytoplasmic sperm injection(Half-ICSI)fertilization,which may optimize laboratory fertilization outcomes.
作者
徐金凤
张斌
李东川
王庆凯
段新崇
孟繁玉
蔡立义
XU Jinfeng;ZHANG Bin;LI Dongchuan;WANG Qingkai;DUAN Xinchong;MENG Fanyu;CAI Liyi(Department of Reproductive Medicine,Hebei Maternity Hospital,Shijiazhuang 050011,Hebei,China;Shijiazhuang Technology Innovation Center of Precision Prevention and Control of Birth Defects,Shijiazhuang 050011,Hebei,China)
出处
《中国性科学》
2025年第10期23-27,共5页
Chinese Journal of Human Sexuality
基金
石家庄市科技局项目(221200323)。
关键词
精子顶体酶活性
体外受精
受精率
补救率
Sperm acrosome enzyme activity
In vitro fertilization
Fertilization rate
Salvage rate
