男性染色体多态性对精子质量及体外受精/卵胞质内单精子显微注射结局的影响

目的研究男方染色体多态性对精子质量及体外受精-胚胎移植(IVF-ET)结局的影响。方法回顾性比较IVF/卵胞质内单精子显微注射(ICSI)-ET助孕治疗的男方染色体多态(n=131)和正常对照夫妇(n=160)的妊娠结局,观察男方的精子质量和受精情况、临床妊娠率、早期流产率。结果男方染色体多态组中严重少/弱精子症(19.85%)比例显著高于染色体正常组(5.00%,P0.001),Yqh+在严重少/弱精子症(38.46%)中的比例最高;Yqh-也高达15.38%,1qh+在严重少/弱精子症组是最常见的常染色体多态类型(19.23%);染色体多态组的女方年龄、体质量指数(BMI)、基础性激素水平均无统计学差异(P0.05),男方前向精子率(PR%)、精子正常率以及获卵数、移植胚胎数均无统计学差异(P0.05)。染色体多态组行IVF-ET助孕治疗后,其着床率(17.42%)、临床妊娠率(28.17%)均显著低于正常对照组(32.26%,59.38%)(P0.05);并且早期流产率(11.11%)高于对照组(2.04%),但差异无统计学意义(P0.05)。染色体多态组行ICSI-ET助孕治疗后与正常对照组妊娠结局无统计学差异(P0.05),优质胚胎率(75.24%±23.68%)还高于正常对照组(49.97%±29.31%)(P0.05)。行ICSI-ET助孕的男方染色体多态患者其着床率(34.78%)以及临床妊娠率(52.00%)显著高于行IVF-ET助孕的男方染色体多态患者(17.42%,28.17%)(P0.05)。结论男性染色体多态性患者中严重少/弱精子的比例增加,男性染色体多态不利于IVF妊娠结局,对ICSI影响较小。

Effects of male chromosomal polymorphism on spermatozoa quality and the outcome of in vitro fertilization/intracytoplasmic sperm injection treatment

Objective To explore the effect of male chromosomal polymorphism on spermatozoa quality and in vitro fertilization/intracytoplasmic sperm injection-embryo transfer (IVF/ICSI-ET) outcomes.Methods A retrospective analysis was performed in 131 couples with male chromosomal polymorphism as study group,and 160 couples with normal chromosomes as control group.Results There was a statistically significant difference about the ratio of severe oligozoosperrnia/asthenospermia between study group (19.85％) and control group (5.00％,P＜0.001).Yqh+ was the most frequently occurring in patients with severe oligozoospermia/asthenospermia (38.46％).The secondary was Yqh-(15.38％).lqh+ was the most frequently occurring in men with autosomal polymorphism with severe oligozoospermia/asthenospermia (19.23％).There were no significant differences in the female age,female body mass index (BMI),female basic sex hormone level,PR％ and the proportion of normal spermatozoa,number ofoocytes retrieved and transplantation between study group and control group.When undergoing IVF-ET treatment,the implantation rate (17.42％),the clinical pregnancy rate (28.17％) in study group were significantly lower than those in control group (32.26％,59.38％)(P＜0.05).There was no significant increase in early abortion rate between the two groups.There was no significant difference in clinical outcomes between the two groups when undergoing ICSI-ET treatment.In addition,the good-quality embryo rate was higher in study group (75.24％± 23.68％) than in control group (49.97％± 29.31％) (P＜0.05).In study group,the implantation rate (34.78％) and the clinical pregnancy rate (52.00％) were significantly higher among the patients undergoing ICSI-ET treatment than those undergoing IVF-ET treatment (17.42％,28.17％) (P＜0.05).Conclusion It suggests that male chromosome polymorphism can increase the ratio of severe oligozoospermia/asthenospermia.Male chromosome polymorphism has an adverse effect on IVF reproductive outcome and has no obvious effect on ICSI reproductive outcome.