少精子症患者Y染色体微缺失与否与单精子卵细胞胞浆内注射的相关性

目的:观察探讨Y染色体微缺失少精子症患者对单精子卵细胞胞浆内注射治疗结果的影响。方法:选取我院2013年1月至2016年4月接受卵细胞胞浆内单精子注射辅助治疗的23例确诊为Y染色体微缺失特发性少精症不育患者,及同期在我院接受单精子卵细胞胞浆内注射辅助治疗的无Y染色体微缺失的100例少精子不育患者,分为缺失组及无缺失组。比较接受辅助治疗的两组不育患者在男方精液参数、女方年龄、获卵数、受精率、卵裂率,早晚期流产率等指标数值上差异,分析少精子症不育患者Y染色体微缺失对单精子卵细胞胞浆内注射辅助治疗结果的相关性。结果:缺失组患者在女性年龄,不育年限、获卵数上与无缺失组无统计学差异(P0.05)。缺失组患者在正常形态精子数量,精子浓度,子宫内膜厚度上与无缺失组具有统计学差异(P0.05)。缺失组患者在卵裂率,可移植胚胎率上与无缺失组无统计学差异(P0.05)。缺失组患者在受精率,优质胚胎率均低于无缺失组,且早期流产率,晚期流产率显著高于无缺失组(P0.05)。结论:Y染色体微缺失的少精子症不育患者在单精子卵细胞胞浆内注射治疗结局中,受精率、胚胎质量明显降低,流产率略微提高,故Y染色体微缺失会影响单精子卵细胞胞浆内注射治疗结果。男性患者面临不育问题时选择胚胎植入治疗时是否选择遗传学诊断,应在遗传咨询后尊重患者意愿。

Correlation of Y chromosome deletion with intracytoplasmic sperm injection in patients with oligospermia

Objectives:To investigate the effect of Y chromosome deletion on the outcome of intracytoplasmic sperm injection in patients with oligospermia.Methods:23 patients with oligospermia due to Y chromosome deletion in our hospital from January 2013 to April 2016 were selected as the deletion group and treated by intracytoplasmic sperm iujection.Another 100 oligospermia patients without Y chromosome deletion were selected as non-deletion group and treated by intracytoplasmic sperm injection.The semen parameters,spouse's age,number of eggs,number of fertilization rate,cleavage rate,early and late abortion rate and other indicators were compared between the two groups,to analyze the correlation of Y chromosome deletion and the outcome of intracytoplasmic sperm injection.Results:There was no differences in spouse's age,years of infertility and number of eggs between the two groups (P ＞ 0.05).Differences in the number of normal sperm,sperm concentration,and endometrial thickness were significant between the groups (P ＜ 0.05).Differences in the cleavage rate and embryo rate were not signiifcnat between the two groups (P ＞ 0.05).The fertility rate and rate of high quality embryos in the deletion group were lower and the rate of early and late abortion was significantly higher than those of non-deletion group correspondingly (P ＜ 0.05).Conclusion:For patients with oligospermia due to Y chromosome deletion,the fertilization rate,embryo quality decreased significantly and abortion rate increased slightly after intracytoplasmic sperm injection.Therefore,the Y chromosome deletion can affect the outcome of intracytoplasmic sperm injection and patient's will should be respected after genetic counseling when choosing the intracytoplasmic sperm injection to treat oligospermia.