精子畸形程度对常规体外受精-胚胎移植治疗的影响

目的 探讨精子畸形程度对常规体外受精(IVF)-胚胎移植治疗的影响. 方法 2007-2008年接受常规体外受精-胚胎移植105对夫妇男方精液进行分析,按精子正常形态百分率分为3组,正常精子形态组(精子正常形态≥15%)54例、轻度畸形精子组(精子正常形态10%～15%)26例、中度畸形精子组(精子正常形态5%～10%)25例,观察精子畸形程度对IVF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①精子形态正常组与轻度畸形组受精率(79.4%与78.3%)、卵裂率(104.6%与98.6%)、优质胚胎率(58.1%与53.9%)、植入率(31.7%与30.8%)、妊娠率(48.1%与42.3%)及流产率(13.0%与18.2%)比较差异均无统计学意义(P>0.05).②精子形态正常组与中度畸形组受精率(63.9%)、优质胚胎率(48.2%)、植入率(16.7%)、妊娠率(24.0%)比较差异有统计学意义(P<0.05).而卵裂率(102.9%)、流产率(28.6%)比较差异无统计学意义(P>0.05).③轻度畸形组与中度畸形组受精率、优质胚胎率比较差异有统计学意义(P<0.05),植入率(30.8%与16.7%)、妊娠率(42.3%与24.0%)、卵裂率(98.6%与102.9%)、流产率(18.2%与28.6%)比较差异无统计学意义(P>0.05).结论 中度畸形精子患者常规IVF受精率、优质胚胎率、植入率和妊娠率有一定影响;轻度畸形精子对常规IVF影响不大.

Influence of the human sperm abnormalities on conventional in-vitro fertilization therapy outcome

Objective To observe the influence of the sperm abnormalities on conventional invitro fertilization therapy outcome. Methods Sperm of 105 infertile husband's semen was analyzed. The patients were divided into three groups according to the sperm morphology observed Using Kruger 's criteria: normal sperm morphology group (sperm normal morphology ≥ 15 % ), mild sperm abnormalities group( sperm normal morphology 10%- 15%), middle sperm abnormalities group (sperm normal morphology 5 % - 10 % ). Fertilization rate, cleavage rate, good quality embryo rate, implantation rate, clinical pregnancy rate and abortion rates were compared to study the influence of the sperm abnormalities on conventional IVF outcome. Results ①Fertilization rate(79.4 % vs 78.3 % ), cleavage rate(104. 6% vs98. 6%), good quality embryo rate(58. 1% vs 53. 9%), implantation rate (31.7% vs 30. 8%), clinical pregnancy rate(48.1% vs 42. 3%)and abortion rates(13.0% vs 18. 2%)were not significantly different between normal sperm morphology group and mild sperm abnormalities group(P>0. 05). ②The fertilization rate (79.4% vs 63.9%), good quality embryo rate(58. 14% vs 48.23%), implantation rate (31.7% vs 16. 7%) and clinical pregnancy rate(48.1%vs24.0%) of the normal sperm morphology group were higher than middle sperm abnormalities group(P<0.05). The abortion rates(13.04% vs 28. 57%) and cleavage rates(104.6% vs 102.9%) were not significantly different(P>0. 05). ③The fertilization rate (78.3% vs 63.9%), good quality embryo rate (53. 9%vs 48. 2%) of the mild sperm morphology group were higher than middle sperm abnormalities group(P <0.05). Implantation rate (30.8% vs 16. 7%) , clinical pregnancy rate(42.3% vs 24.0%) , abortion rates(13. 0% vs 28. 6%) and cleavage rates(104.6% vs 102.9%) were not significantly different (P>0. 05). Conclusions There is a significant influence of middle sperm abnormalities on IVF fertilization rate, good quality embryo rate, implantation rate and clinical pregnancy rate. However, it could not be influenced on mild sperm abnormalities.