精子DNA碎片与体外受精结局的关系

目的:探讨精子DNA碎片与体外受精(in vitro fertilization,IVF)结局的关系。方法:采用染色质扩散实验(sperm chromatin dispersion,SCD)对242例接受IVF的男方进行精子DNA碎片率(DNAfragmentation index,DFI)检测,按照WHO标准进行精液常规分析,将精子DFI、精液常规参数和IVF受精率、卵裂率、可移植胚胎率、优质胚胎率进行Spearman相关分析,将精子DFI、精液常规参数对生化妊娠、临床妊娠的影响进行Logistic回归分析。结果:精子DFI与精子前向活动率呈负相关(r=-0.355,P<0.001);密度梯度法处理前、后精子DFI均与IVF受精率呈负相关(r=-0.223,P<0.001)(r=-0.136,P<0.05);精子DFI、精液常规参数与卵裂率、可移植胚胎率、优质胚胎率无相关性;精子DFI与生化妊娠、临床妊娠结局无相关性。结论:精子DFI影响精子活力与IVF受精率,精子DFI检测对预测IVF受精率有一定的临床意义。

Relationship between Sperm DNA Fragmentation and the Outcomes of in vitro Fertilization

Objective： To evaluate the effects of sperm DNA fragmentation index on IVF outcomes. Methods： Sperm DNA fragmentation index of 242 infertile couples participating in IVF program was analyzed by sperm chromatin dispersion （SCD） test. Conventional semen analysis was according to WHO standard. Spearman correlation between sperm DNA fragmentation index （DFI）, conventional semen parameters and iVF fertilization rates, cleavage rate, transferable embryo rate and good quality embryo rate was analyzed. The effect of DFI and sperm parameters on biochemical pregnancies and clinical pregnancies outcome was analyzed by Logistic regression. Results： There was a negative statistical correlation between DFI and sperm forward motility （r=-0.355, P〈0.001）. A significant negative relationship was found between IVF fertilization rate and sperm DFI before and after density gradient processed （r=-0.223, P〈0.001, r=-0.136, P〈0.05）. However, no correlation was found between sperm DFI and cleavage rate, good quality embryo rate and transferable embryo rate. Sperm DFI had no significant effect on biochemical pregnancies and clinical pregnancies outcome. Conclusion： Sperm DFI affects sperm motility and IVF fertilization rates. Measurement of sperm DFI might have a certain extent clinical significance for predicting IVF fertilization rate.