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1.
High seminal reactive oxygen species (ROS) are related to poor semen quality and impaired fertilization. We aimed at finding whether there is an association between ROS and fertilization, embryo quality and pregnancy rates after conventional in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI). In prepared semen of 147 male partners of infertile couples, ROS were assessed with luminol chemiluminescence. Spermiogram was assessed in native semen. ROS were negatively correlated with standard sperm characteristics and testicular volume, and positively with abnormal sperm head morphology. Fertilization rate and embryo morphology on day 2 and on day 4 were assessed in 41 IVF and 106 ICSI cycles. The influence of maternal (female age and number of oocytes) and paternal (sperm motility, morphology and ROS) factors on fertilization and embryo quality were assessed by means of regression analyses. After IVF, fertilization and pregnancy rates were negatively associated with ROS level (p = 0.031 and 0.041, respectively). In case of higher ROS, significantly fewer ICSI-derived embryos (p = 0.036) reached the morula-blastocyst stage on day 4. High seminal ROS levels are associated with impaired sperm fertilizing ability and lower pregnancy rates after IVF. In ICSI, a negative association of ROS with embryo development to the blastocyst stage has been observed.  相似文献   

2.
In this study, our purpose was to investigate the possible effect of paternal obesity on intracytoplasmic sperm injection (ICSI) outcomes on the basis of clinical pregnancy outcome. Antropometric measurements of 155 couples, referred to our infertility clinic and who underwent an ICSI cycle, have been evaluated. The study sample were divided into three groups with respect to paternal body mass index (BMI), as normal weight (BMI: 20–24.9), overweight (BMI: 25–29.9) and obese (BMI ≥ 30). Results of conventional semen analysis were also analysed. Clinical pregnancy data, including fertilisation rate, implantation rate, clinical pregnancy rate and live birth rate, were evaluated. Paternal obesity was a significant negative factor for sperm concentration and sperm motility (P = 0.03 and P = 0.01 respectively). A significant decrease of clinical pregnancy rate and live birth rate was associated with increased paternal BMI (P = 0.04 and P = 0.03 respectively). We have not determined a significant difference among groups in terms of fertilisation rate and implantation rate. This study demonstrates that increasing paternal BMI has a negative influence on ICSI success, including clinical pregnancy rate and live birth rate. There is a need for further studies to point the importance of lifestyle changes in order to overcome the negative influence of paternal obesity on couple's fertility.  相似文献   

3.
目的:探讨正常形态精子百分率对体外受精-胚胎移植(IVF-ET)治疗结局及新生儿的影响。方法:采用WHO严格标准法将精液标本分为3组:中度畸形组:正常形态精子百分率5%~10%,轻度畸形组:10%<正常形态精子百分率<15%,正常组:正常形态精子百分率≥15%,比较各组间正常受精率、卵裂率、优质胚胎率、种植率、临床妊娠率及新生儿情况。结果:各组间患者年龄(男、女方)差异不显著(P>0.05);中度畸形组正常受精率显著低于轻度畸形组(63.70%vs73.74%,P<0.05),但与正常组差异无统计学意义(63.70%vs68.05%,P>0.05);正常组的优质胚胎率最高,显著高于中度畸形组(44.83%vs35.75%,P<0.05),其他各指标3组间差异无统计学意义(P>0.05);280个移植周期共分娩125个婴儿,其中单胎分娩73例,双胎分娩26例,出生婴儿未见先天异常,3组间流产率、异位妊娠率、孕周、早产率、出生体重差异无统计学意义(P>0.05)。结论:正常形态精子百分率为5%~10%对常规体外受精的受精率无影响,但显著降低优质胚胎率,而10%<正常形态精子百分率<15%对常规体外受精治疗结局的各项指标均无明显影响;正常形态精子百分率在预测IVF-ET的助孕结局及新生儿情况方面存在一定局限性。  相似文献   

4.
BackgroundObesity has previously been related to reduced female fertility, with prolonged waiting time to pregnancy among women with a body mass index (BMI) >35 kg/m2 but there are few studies investigating the relationship between high BMI, bariatric surgery, and male fertility.ObjectivesThe primary objective of this article was to investigate the effect of bariatric surgery on in vitro fertilization (IVF) outcomes in a cohort of men with morbid obesity who underwent sleeve gastrectomy (SG).SettingUniversity hospital, bariatric surgery unit.MethodsPre- and postsurgery data on patient age, body mass index (BMI), and variables related to male fertility (semen volume, concentration, progressively motile sperm count, and sperm morphology) were collected; assisted reproductive technology outcomes before and after bariatric surgery were measured by the number of metaphase II oocytes; the number of top-quality oocytes and embryos; the number of fertilized oocytes; the number of transferred embryo; the implantation rate; the pregnancy rate; the live birth rate and the miscarriage rate.ResultsThirty-five men with obesity and idiopathic infertility were included in this study. We found a significant increase, after bariatric surgery, in semen volume, total sperm concentration, progressively motile sperm count, and sperm morphology. Considering IVF outcomes, mean number of top-quality oocytes, mean number of fertilized oocytes, mean number of embryos obtained, and top-quality embryos were significantly increased after bariatric procedure.ConclusionBariatric surgery is confirmed to be safe and effective in increasing the outcomes of assisted reproductive technology treatment also in case of infertile men with obesity, both in terms of pregnancy and live birth rate.  相似文献   

5.
目的 探讨OHSS高风险患者全胚冷冻后冻融胚胎移植(FET)的时机.方法 回顾性分析2014年6月至2018年12月于西北妇女儿童医院生殖中心接受IVF/ICSI-ET治疗,因OHSS高风险而全胚冷冻的患者共2 060例.根据取卵日距第1次FET日的时间长短分为两组:时间间隔≤40 d为立即FET组,共196例;时间间...  相似文献   

6.
In this study, our objective was to evaluate the impact of testicular histopathology on the outcome of intracytoplasmic sperm injection (ICSI) cycles of patients with nonobstructive azoospermia and correlate with clinical and hormonal parameters. For this purpose, 271 patients with nonobstructive azospermia (NOA) who underwent testicular sperm extraction (TESE) for ICSI cycles were retrospectively evaluated for sperm retrieval, fertilisation, embryo cleavage, clinical pregnancy and live birth rates among different testicular histology groups. We also correlated hormonal and clinical factors with histological findings. Sperm retrieval and fertilisation rates (FR) were found to be significantly different among all testicular histological groups of NOA except for embryo cleavage, clinical pregnancy and live birth rates. Furthermore, serum follicle stimulating hormone (FSH) level was the most significant variable to predict sperm recovery on TESE. Separate analyses within each testicular histological group revealed that higher FSH was also associated with lower pregnancy rates in only maturation arrest group. In conclusion, testicular histology significantly influences sperm retrieval and FRs but not pregnancy and live birth rates in nonobstructive azoospermia. However, FSH is the best predictor of a successful TESE.  相似文献   

7.
To determine whether semen quality in Slovenians has changed over 14 years (1983-96), we analysed retrospectively the semen of 2343 healthy men with a normal spermiogram, who were partners of women with tubal infertility included in the IVF-ET programme. Age at semen collection, duration of sexual abstinence, semen volume, sperm concentration, total sperm count, percentage of spermatozoa with progressive motility, and normal morphology were determined. Multiple regression analysis was used to assess the changes in sperm characteristics according to the year of semen collection, year of the man's birth and the duration of sexual abstinence. Semen volume, sperm concentration, sperm count and total sperm motility did not change between 1983 and 1996, whereas between 1988 and 1996 rapid progressive sperm motility decreased by 0.95% per year (p < 0.0001). Semen volume, sperm concentration, and sperm count increased with duration of sexual abstinence. After adjustment for the year of semen collection and duration of sexual abstinence, multiple regression analysis showed that sperm concentration decreased by 0.67% per each successive year of birth (p = 0.03). Thus the sperm concentration decreased from 87.6 x 10(6)/mL in men born in the 1940s to 77.3 x 10(6)/mL in those born between 1956 and 1960. After 1960, sperm concentration was found to increase. In 2343 healthy men, no decline in semen quality, except in rapid progressive motility, was observed in the study period. Lower sperm concentration was found among men born between 1950 and 1960. This could be related to worse socio-economic status, stress or negative environmental factors in this time period.  相似文献   

8.
This study was performed to evaluate the independent influence of paternal age affecting embryo development and pregnancy using testicular sperm extraction (TESE)‐intracytoplasmic sperm injection (ICSI) in obstructive azoospermia (OA) and nonobstructive azoospermia (NOA). Paternal patients were divided into the following groups: ≤30 years, 31–35 years, 36–40 years, 41–45 years and ≥46 years. There were no differences in the rates of fertilisation or embryo quality according to paternal and maternal age. However, clinical pregnancy and implantation rates were significantly lower between those ≥46 years of paternal age compared with other age groups. Fertilisation rate was higher in the OA than the NOA, while embryo quality, pregnancy and delivery results were similar. Clinical pregnancy and implantation rates were significantly lower for patients ≥46 years of paternal age compared with younger age groups. In conclusion, fertilisation using TESE in azoospermia was not affected by the independent influence of paternal age; however, as maternal age increased concomitantly with paternal age, rates of pregnancy and delivery differed between those with paternal age <41 years and ≥46 years. Therefore, paternal age ≥46 years old should be considered when applying TESE‐ICSI in cases of azoospermia, and patients should be advised of the associated low pregnancy rates.  相似文献   

9.
目的探讨卵裂期和囊胚期胚胎移植对妊娠安全性及出生性别比的影响。方法回顾性分析2012年8月至2015年8月在我院行助孕治疗的19 684个周期的临床资料,根据胚胎移植时间及方式的不同进行分组:卵裂期胚胎移植组(D3组,13 968个周期)和囊胚移植组(D5组,5 716个周期),D3组又分为D3鲜胚组(13 566个周期)和D3冻胚组(402个周期);D5组分为D5鲜胚组(153个周期)和D5冻胚组(5 563个周期)。分别比较各组的妊娠结局及出生男/女性别比情况。结果 D3组的移植胚胎数显著高于D5组(P0.05),但临床妊娠率、胚胎种植率、活产率均显著低于D5组(P0.05),出生男/女性别比亦显著低于D5组(P0.05),多胎率、流产率、早产率、围生儿死亡率和低出生体重儿率则显著高于D5组(P均0.05);D3鲜胚组的胚胎种植率显著低于D5鲜胚组(P0.05),多胎率、流产率、早产率和低出生体重儿率显著高于D5鲜胚组(P均0.05);D3冻胚组的临床妊娠率、胚胎种植率、剖宫产率和活产率显著低于D5冻胚组,流产率则显著高于D5冻胚组(P均0.05);D3鲜胚组的临床妊娠率、胚胎种植率和活产率显著低于D5冻胚组(P0.05),出生性别比亦显著低于D5冻胚组(P0.05),多胎率、流产率、早产率、剖宫产率、围生儿死亡率、胎儿畸形发生率、低出生体重儿率则显著高于D5冻胚组(P均0.05)。结论囊胚移植在移植较少胚胎的情况下,仍可获得较高的种植率、临床妊娠率和活产率,同时降低多胎率,且不增加过期产、巨大儿和胎儿畸形的风险。但其可能会提高出生男/女性别比,其对性别比的长远影响尚需进一步深入研究。  相似文献   

10.
Testicular size, semen characteristics and serum reproductive hormone levels were studied in 1239 normal Chinese men. The mean testicular size of 17 ml in this group of subjects was similar to other reports in Orientals but was smaller than that reported in Caucasians. Semen volume, and the sperm count, motility and morphology were comparable to those described for Caucasian subjects. The cervical mucus penetration test (Kremer's test) and the zona-free hamster egg penetration test were also studied in some of the subjects. Age showed a positive correlation with the serum levels of FSH and LH, which were highly correlated with each other. Sperm concentration and the total sperm count were positively correlated with testicular volume, the length of abstinence, the % of sperm with an oval head, and the zona-free hamster egg penetration test, but were negatively correlated with serum FSH. Sperm motility was negatively correlated with the duration of abstinence but was positively correlated with the % normal sperm. The results constitute a normal data base from Chinese men for comparison with studies in male infertility and fertility regulation.  相似文献   

11.
目的 探讨间苯三酚对IVF/ICSI鲜胚移植周期临床妊娠结局的影响.方法 回顾性分析2016年1月至2019年6月期间在我院生殖中心初次接受IVF/ICSI助孕治疗的2 110周期患者的临床资料,根据鲜胚移植后是否使用间苯三酚,分为间苯三酚组(n=474)和对照组(n=1 636);各入组患者再根据鲜胚移植的胚胎类型不...  相似文献   

12.

Purpose

We examined how transurethral resection of the ejaculatory ducts, performed for infertility, affects semen quality in patients with azoospermia and oligo-asthenospermia.

Materials and Methods

A retrospective review was done of 46 cases of transurethral resection of the ejaculatory ducts for ejaculatory duct obstruction, confirmed by transrectal ultrasound. Clinical course and semen quality were assessed by semen parameter indications.

Results

In 65 percent of the patients transurethral resection of the ejaculatory ducts improved semen quality (greater than a 50 percent increase in total motile sperm count) and 20 percent initiated a pregnancy an average of 6.1 months postoperatively. Statistically significant increases in total motile sperm count were achieved in men with azoospermia and those treated for oligo-asthenospermic indications; the improvement also was shown to be sustainable. Complications occurred in 20 percent of the men.

Conclusions

Significant and durable semen quality improvement can be achieved after transurethral resection of the ejaculatory ducts for all surgical indications. In most unsuccessful cases the reason for failure is unclear.  相似文献   

13.
目的比较长方案添加人绝经期促性腺激素(HMG)时机对供精体外受精-胚胎移植(IVF-D)结局的影响。方法回顾性分析2010年1月至2016年1月在本院生殖中心就诊进行IVF-D助孕的371例不育患者资料。所有患者均采取长方案进行控制性促排卵(COH),按照添加HMG时机分为两组:卵泡14mm时添加HMG为A组(227个周期),与rFSH同时添加HMG为B组(144个周期)。比较两组Gn总量及天数、HCG日E_2和P、获卵数、2PN率、成胚数、优胚率、胚胎着床率、临床妊娠率、流产率和活产率,并以年龄进行亚组分析。结果与B组相比,A组Gn总量和天数、HCG日的孕酮(P)水平以及优胚率均显著性降低,差异有统计学意义(P0.05);两组间HCG日E_2、获卵数、2PN率、成胚数、胚胎着床率的差异均无统计学意义,A组临床妊娠率和活产率均高于B组,流产率低于B组,但差异无统计学意义;35岁的患者中,A组比B组的Gn总量和天数少,差异有统计学意义(P0.05);≥35岁的患者中,B组的优胚率比A组多,差异有统计学意义(P0.05)。结论长方案促排卵于卵泡晚期添加HMG在不影响妊娠结局的情况下,可以减少Gn用量,降低费用。  相似文献   

14.
Leucocytes are present throughout the male reproductive tract but the clinical significance of leucocytic infiltration in the human ejaculate is controversial. The World Health Organization (WHO) defines leucocytospermia as the presence of peroxidase-positive leucocytes in concentrations of > or =1 x 10(6)/mL of semen. The goals of this study were to clarify the relationship between leucocytospermia and semen parameters including sperm concentration, progressive and total motility before and after semen preparation, and intracytoplasmic sperm injection (ICSI) outcomes, including fertilization, embryo development, embryo morphology, cleavage and pregnancy rates. We compared the semen parameters and ICSI outcome of 34 leucocytospermic and 36 non-leucocytospermic control couples who were undergoing ICSI because of male factor infertility including oligo and/or astheno and/or teratozoospermia. Semen parameters including progressive motility rate (1.5% vs. 3%) and sperm concentrations (12 vs. 29 million/mL) were significantly lower in the leucocytospermic group compared with the control group. Other semen parameters were not affected by the presence of leucocytes. ICSI outcome, including fertilization (82% vs. 87%) and embryo development rates (79% vs. 86%) were significantly lower in the leucocytospermic group compared with the control group although there were no statistical difference for embryo quality, embryo cleavage and pregnancy rates. These results indicate that some semen parameters and the outcome of ICSI were negatively affected by the presence of leucocytospermia.  相似文献   

15.
目的 探讨精子畸形程度对常规体外受精(IVF)-胚胎移植治疗的影响. 方法 2007-2008年接受常规体外受精-胚胎移植105对夫妇男方精液进行分析,按精子正常形态百分率分为3组,正常精子形态组(精子正常形态≥15%)54例、轻度畸形精子组(精子正常形态10%~15%)26例、中度畸形精子组(精子正常形态5%~10%)25例,观察精子畸形程度对IVF受精率、卵裂率、优质胚胎率、着床率、妊娠率及流产率的影响. 结果①精子形态正常组与轻度畸形组受精率(79.4%与78.3%)、卵裂率(104.6%与98.6%)、优质胚胎率(58.1%与53.9%)、植入率(31.7%与30.8%)、妊娠率(48.1%与42.3%)及流产率(13.0%与18.2%)比较差异均无统计学意义(P>0.05).②精子形态正常组与中度畸形组受精率(63.9%)、优质胚胎率(48.2%)、植入率(16.7%)、妊娠率(24.0%)比较差异有统计学意义(P<0.05).而卵裂率(102.9%)、流产率(28.6%)比较差异无统计学意义(P>0.05).③轻度畸形组与中度畸形组受精率、优质胚胎率比较差异有统计学意义(P<0.05),植入率(30.8%与16.7%)、妊娠率(42.3%与24.0%)、卵裂率(98.6%与102.9%)、流产率(18.2%与28.6%)比较差异无统计学意义(P>0.05).结论 中度畸形精子患者常规IVF受精率、优质胚胎率、植入率和妊娠率有一定影响;轻度畸形精子对常规IVF影响不大.  相似文献   

16.
A previous prospective study using matched samples found that sperm with low hypoosmotic swelling (HOS) scores had no adverse effect on fertilization rates but markedly reduced pregnancy and implantation rates. The present study attempted to corroborate or refute the aforementioned study by comparing pregnancy rates in donor-recipient pairs using shared oocytes where the sperm of one of the two males had low HOS scores. The results found no pregnancies from the sperm with low HOS scores versus a 41% live delivered rate for those with normal scores. However, fertilization rates were not affected. This retrospective study thus confirms that sperm with low HOS scores cause implantation defects of the embryos that are formed without affecting fertilization rate, embryo cleavage rate, or embryo quality.  相似文献   

17.
目的 比较冷冻精子与新鲜精子进行卵胞浆内单精子注射 ( ICSI)助孕技术的治疗效果。 方法 对 1 6 1对不育夫妇进行 1 6 3个辅助生殖技术治疗周期 ,其中采用冷冻精子 47个周期 ,比较了冷冻精子组与新鲜精子组 1 1 6个周期的受精率、卵裂率、A级胚胎率与临床妊娠率。 结果 冷冻精子组 (组 I)的受精率为 77.6 %、卵裂率为 92 .9%、A级胚胎率为 6 5.4%、临床妊娠率为 45.5% ;新鲜精液严重异常组 (组 II)分别为 54 .4%、94.0 %、45.7%及 2 5.0 % ;新鲜精液轻、中度异常组 (组 III)分别为 73 .5%、92 .5%、46 .8%及 2 9.3 %。组 I的受精率、A级胚胎率和临床妊娠率明显高于组 II( P<0 .0 5) ;与组 III比较无显著性差异 ( P>0 .0 5)。 结论 患者本身的精子质量直接影响 ICSI的受精率 ,精子冷冻复苏处理不影响 ICSI的受精率、卵裂率和优质胚胎率  相似文献   

18.
目的:按WHO《人类精液检查与处理实验室手册》第5版(《WHO5》)标准探讨正常形态精子百分率对常规体外受精-胚胎移植的助孕结局及新生儿健康状况的预测价值。方法:采用《WHO5》标准把研究对象789例分为畸形精子症组(正常形态精子百分率<4%,35例)和正常组(正常形态精子百分率≥4%,754例),比较两组间正常受精率、卵裂率、优胚率、种植率、临床妊娠率、流产率及新生儿情况。结果:①两组间患者年龄(男、女方)、获卵数、女方平均身高及平均体重指数差异不显著(P>0.05);畸形精子症组的正常受精率、卵裂率、优胚率、周期冷冻率、种植率及移植周期妊娠率略低于正常组,而其流产率略高于正常组,但两组间各指标差异均无统计学意义(P>0.05);②除外继续妊娠(畸形精子症组1例,正常组140例),随访789个移植周期已分娩228个婴儿,畸形精子症组15个(9单胎+3双胎),正常组213个(141单胎+36双胎),出生婴儿无先天性缺陷,两组间孕周、早产率、低体重发生率差异均无统计学意义(P>0.05)。结论:按《WHO5》标准仅通过精子形态预测体外受精-胚胎移植的助孕结局及新生儿情况具有一定局限性。  相似文献   

19.
目的通过检测男性不育症患者精浆中存在的睾丸特异piRNA与精子DNA损伤程度的关系,探讨其对精子DNA完整性及辅助生殖技术(ART)结局的影响。方法分析149例男性不育症患者精液质量及精子DNA完整性;按精子DNA碎片指数(DFI)将不育症患者分为:A组(DFI≤15%)、B组(15%DFI30%)、C组(DFI≥30%),采用实时荧光定量聚合酶链式反应(Q-PCR)检测各组患者精浆中piRNA-013423和piRNA-023386的表达量,比较各组患者受精率、卵裂率、优胚率、生化妊娠率及临床妊娠率的差异。结果与A、B组比较,C组的精子密度、前向活动精子、精子活动率、正常形态率均明显下降(P0.05),A、B两组比较,B组精子活动率下降(P0.05)。A、B、C三组中,C组患者piRNA-013423、piRNA-023386表达均低于A、B组(P0.01);C组患者受精率、卵裂率、优胚率、生化妊娠率及临床妊娠率均低于A、B组(P0.01)。结论男性不育症患者存在精子DNA不同程度的损伤,精浆中piRNA的水平与精子DNA完整性有关,DNA完整性差的患者精浆piRNA表达降低,且影响ART临床结局。提示piRNA可能通过某些信号通路调控精子DNA损伤,但具体机制需要下一步深入研究探讨。  相似文献   

20.
本研究旨在确定乙型肝炎病毒(HBV)感染对精子质量和辅助生殖技术治疗结局的影响。分析2008年1月至2009年12月于浙江大学附属妇产科医院寻求辅助生育治疗的916例男性(457例乙型肝炎病毒携带者和459例阴性对照男性)的精液参数;将2004年1月至2009年12月期间的男性乙肝病毒携带的587个常规体外受精(In vitro fertilisation,IVF)周期和325个单精子卵细胞浆内注射(Intracytoplasmic sperm injection,ICSI)周期作为阳性观察组,根据取卵日期、女方年龄及ART受精方式通过统计软件以1:1比例匹配,设立夫妇双方均为HBsAg阴性的对照组(587个IVF周期,324个ICSI周期),分析两组间的辅助生殖治疗结局。与对照组相比,乙肝携带者表现有较低的精液体积、精子总数以及较差的精子活动力和形态学表现(P〈0.05);乙肝男性夫妇接受ICSI治疗后,双原核(2PN)受精率、优质胚胎率、胚胎着床率以及临床妊娠率均显著性降低俨〈0.05);而两组病人间的IVF治疗结局差异无显著性(P〉0.05)。通过Logistic回归分析发现乙肝病毒感染作为一个独立的因素增加少弱精子症的发生以及降低ICSI治疗周期的胚胎着床率和临床妊娠率(P〈0.05)。我们的研究结果提示了男性乙型肝炎病毒感染与较差的精子质量和ICSI治疗结局有关,而对IVF治疗结局没有明显的影响。  相似文献   

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