精子DNA完整性对体外受精-胚胎移植结局的影响

目的探讨精子DNA损伤对体外受精-胚胎移植（IVF-ET）结局的影响。方法：142对夫妇接受142周期IVF-ET治疗,采用染色质扩散实验对男方精液进行精子DNA完整性检测。分析精子DNA碎片指数（DFI）与受精率、2PN受精率、卵裂率及优胚率的相关性;根据DFI值分为DFI〈30%组与DFI≥30%组,比较两组间的种植率、妊娠率和流产率。结果：精子DFI与受精率、2PN受精率及卵裂率均无显著相关性（P〉0.05）,与优胚率具有显著负相关（P〈0.05）。两组间对比,DFI〈30%组的种植率及妊娠率均高于DFI≥30%组,差异有统计学意义（P〈0.05）。DFI≥30%组的流产率高于DFI〈30%组,但差异无统计学意义（P〉0.05）。结论：IVF-ET治疗中,精子DNA损伤对受精率、2PN受精率及卵裂率无影响,但对优胚率、种植率及妊娠率有负面影响,与流产率的关系需更大样本研究。建议将精子DNA完整性分析作为精子功能分析的一个常用项目。

Effect of sperm DNA integrity on in vitro fertilization

Objective To assess the effect of sperm DNA fragmentation on in vitro fertilization（IVF-ET） Methods： The 142 couples accepted 142 IVF-ET cycles.Sperm chromatin dispersion（SCD） was used to analyse sperm DNA integrity.The DNA fragment index（DFI） fertilization rates,2PN fertilization rates,zygote transgene rates,optimal embryo rates were investigated.The cases were divided into DFI30% group and DFI≥30% group,and the results between the two groups were compared.Results No significant correlation of sperm DFI with fertilization rates,2PN fertilization rates,zygote transgene rates were observed（P0.05）,but it was negatively correlated with the optimal embryo rates（P0.05） between the two groups.The implantation rate in DFI30% group was higher than DFI≥30% group,showing significant difference（P0.05）.The abortion rate in DFI30% group was higher than DFI≥30% group,withour showing significant difference（P0.05）.Conclusion： In IVF-ET treatment,the sperm DNA integrity has no effect on fertilization rate,2PN fertilization rates and zygote transgene rates,but has negtive effect on optimal embryo rates,implantation rate and pregnancy rate.It is suggested that sperm DNA integrity be used as an common indicator for sperm function analysis.