上游处理前后正常形态精子百分率与体外受精-胚胎移植结局的关系

目的:探讨取卵当日上游处理前后精子形态与体外受精-胚胎移植(IVF-ET)治疗结局的关系。方法:选取因单纯输卵管因素不孕而拟行IVF-ET治疗的夫妇94对。使用Kruger标准评价取卵当日上游处理前后的精子形态。以正常精子形态百分率10%为界,分别将上游处理前后的精子分成两组:B1组上游处理前正常形态≥10%,B2组<10%;A1组上游处理后正常形态≥10%,A2组<10%。分别比较B1和B2组以及A1和A2组的IVF-ET治疗结局。结果:上游处理前,B1组的受精率、卵裂率、优质胚胎率、妊娠率和胚胎种植率分别为(72.90±4.23)%、(95.20±2.61)%、(23.35±5.19)%、39.58%、18.35%;B2组分别为(71.33±5.10)%、(95.71±2.88)%、(20.18±6.15)%、41.86%、21.28%;各项指标两组之间差异均无统计学意义(P>0.05)。上游处理后,A1组受精率、卵裂率、优质胚胎率、妊娠率、胚胎种植率分别为(72.72±3.35)%、(95.64±2.04)%、(24.39±4.57)%、50.00%、23.87%;A2组分别为(70.27±8.82)%、(94.82±4.94)%、(13.45±7.39)%、9.52%、6.25%;两组之间受精率及卵裂率差别无统计学意义(P>0.05),但A1组的优质胚胎率、妊娠率及种植率明显高于A2组(P<0.05)。结论:取卵当日经上游处理后的正常精子形态百分率对IVF-ET结局有较好的预测价值。

Outcomes of IVF-ET and percentage of morphologically normal sperm before and after swim-up treatment

Objective: To study the relationship between sperm morphology and the outcomes of in vitro fertilization-embryo transfer(IVF-ET) before and after swim-up treatment of sperm on the day of oocyte retrieval.Methods: This study included 94 couples to be treated by IVF-ET for tubal factor infertility.Sperm samples were collected on the day of oocyte retrieval and sperm morphology evaluated according to the Kruger criteria before and after swim-up treatment.Based on the results of morphological evaluation,the sperm samples were divided into groups A1(morphologically normal sperm ≥10% after swim-up treatment),A2(morphologically normal sperm <10% after swim-up treatment),B1(morphologically normal sperm ≥10% before swim-up treatment) and B2(morphologically normal sperm <10% before swim-up treatment).The outcomes of IVF-ET treatment were compared between groups A1 and A2 as well as between B1 and B2.Results: After swim-up treatment,the rates of fertilization,cleavage,good quality embryo,clinical pregnancy and embryo implantation of group A1 were(72.72±3.35)%,(95.64±2.04)%,(24.39±4.57)%,50.00% and 23.87%,respectively,while those of group A2 were(70.27±8.82)%,(94.82±4.94)%,(13.45±7.39)%,9.52% and 6.25%,respectively,the latter three indexes remarkably higher in A1 than in A2(P<0.05),but the differences in the former two not statistically significant(P>0.05).Before swim-up treatment,the above five indexes were(72.90±4.23)%,(95.20±2.61)%,(23.35±5.19)%,39.58% and 18.35% in group B1,as compared with(71.33±5.10)%,(95.71±2.88)%,(20.18±6.15)%,41.86% and 21.28% in group B2,with no statistically significant differences between the two groups(P>0.05).Conclusion: The percentage of morphologically normal sperm after swim-up treatment on the day of oocyte retrieval may be a valuable predictor of the outcomes of IVF-ET.