男性年龄对常规体外受精-胚胎移植结局的影响

目的:研究男性年龄对体外受精-胚胎移植(IVF-ET)治疗结局的影响。方法:按男方年龄将2008至2010年接受常规IVF-ET的夫妇170对分为3组,年龄<35岁组60例、35～39岁组77例,≥40岁组33例,观察男方年龄对IVF的受精率、卵裂率、优质胚胎率、着床率、妊娠率及流产率的影响。结果:3组精液量(3.10±1.22)ml vs(2.84±1.05)ml vs(2.80±0.79)ml]、精子浓度(54.23±26.07)×106/ml vs(60.27±24.80)×106/ml vs(60.21±27.42)×106/ml]、活动率(53.93±13.25)%vs(56.10±16.58)%vs(51.82±15.45)%]相比均无显著性差异(P>0.05),≥40岁组的(a+b)级精子的百分率(40.97±11.91)%]低于<35岁组(48.47±11.78)%]和35～39岁组(46.84±13.51)%],结果有显著性差异(P<0.05),≥40岁组精子正常形态(11.76±5.97)%]与<35岁组(15.25±6.94)%]相比,结果有显著性差异(P<0.05)。男方年龄≥40岁组的受精率(81.52%)、卵裂率(82.61%)、优质胚胎率(52.33%)、植入率(18.06%)、妊娠率(33.33%)与男方年龄<35岁组(分别为83.18%、82.68%、56.99%、22.40%、40.00%)和35～39岁组(分别为78.78%、80.66%、55.01%、21.74%、38.96%)比较,差异无统计学意义(P>0.05)。男方年龄≥40岁组患者的流产率(36.36%)与男方年龄<35岁组(8.33%)相比明显升高,但无统计学差异(P>0.05)。结论:男性年龄对前向运动精子百分率和精子正常形态率有一定影响,而与受精、胚胎质量、植入率、妊娠率、流产率没有明显的相关性。

Influence of male age on the outcome of conventional IVF-ET

Objective:To study the influence of male age on the outcome of conventional IVF-ET.Methods:Based on male age,170 couples undergoing conventional IVF-ET were divided into three groups:<35 yr(n=60),35-39 yr(n=77) and ≥40 yr(n=33).We observed the rates of fertilization,cleavage,good quality embryo,implantation,clinical pregnancy and abortion in different groups.Results:There were no significant differences among the three groups in semen volume(3.10±1.22] ml vs 2.84±1.05] ml vs 2.80±0.79] ml),sperm concentration(54.23±26.07]×106/ml vs 60.27±24.80]×106/ml vs 60.21±27.42]×106/ml) and sperm viability(53.93±13.25] % vs 56.10±16.58] % vs 51.82±15.45] %)(P>0.05).The men of the ≥40 yr group showed a significantly lower percentage of grade a+b sperm(40.97±11.91] %) than those of the <35 and 35-39 yr groups(48.47±11.78]% and 46.84±13.51]%)(P<0.05),and morphologically normal sperm(11.76±5.97]%) than those of the <35 yr group(15.25±6.94]%(P<0.05).The rates of fertilization,cleavage,good quality embryo,implantation,clinical pregnancy were 81.52%,82.61%,52.33%,18.06% and 33.33% in the ≥40 yr group,with no significant differences from those of the <35 yr group(83.18%,82.68%,56.99%,22.40% and 40.00%) and the 35-39 yr group(78.78%,80.66%,55.01%,21.74% and 38.96%)(P>0.05),while the abortion rate was markedly increased in the ≥40 yr group as compared with the <35 yr group(36.36% vs 8.33%,P>0.05).Conclusion:Increasing male age is related with decreasing percentages of progressively motile sperm and morphologically normal sperm,but not obviously with the rates of fertilization,good quality embryo,implantation,pregnancy and abortion.