精子形态对体外受精胚胎移植妊娠结局的影响

目的：分析男性精液参数与卵裂率、优质胚胎率及妊娠率的相关性,探讨体外受精-胚胎移植（IVF-ET）周期中精子形态对精子功能的影响。方法：分析82个受精率100%的IVF-ET周期。以Diff-Quickstain方法染色,密度梯度离心法处理精液,WHO精子形态学标准评估精子形态,精子正常形态率≥14%为正常组,〈14%者为异常组。观察精液处理前后精子参数变化,比较妊娠组与未妊娠组的年龄、移植日子宫内膜厚度和精液各参数的情况。比较精液处理前后精子正常形态率与两组的正常受精率、卵裂率、优质胚胎率和妊娠率。结果：①密度梯度离心法处理后82例精液密度明显降低,活动力明显提高,差别有统计学意义。②精液处理前精子正常形态率：正常组11例（13.41%）,异常组71例（86.59%）;处理后正常组34例（41.46%）,异常组48例（58.53%）。异常组精液处理后正常精子形态的比例提高,中位数（P25,P75）分别为8.15%（6.38%,10.50%）vs.12.41%（9.98%,18.58%）,差别有统计学意义（P〈0.01）。③精液处理前精子正常形态率正常组和异常组的密度和活动力差别无统计学意义（P〉0.05）。④精液处理前后精子正常形态率正常组和异常组的妊娠率和优质胚胎率差异均无统计学意义（P〉0.05）;精子正常形态率正常组的卵裂率高于异常组（P〈0.05）。⑤妊娠组和未妊娠组除男女双方年龄差异有统计学意义外,移植日子宫内膜厚度和各精液参数差异均无统计学意义。结论：精子形态对妊娠结局无预测,密度梯度离心法能提高正常精子形态百分数,需根据精液处理后的结果选择受精方式。

Influence of Sperm Morphology on Pregnancy Result in in-Vitro-Fertilization and Embryo Transfer

Objective:To Analyze the relation between the sperm parameters and cleavage rate,the quality of embryos and the pregnancy rate,investigate the impact of sperm morphology on spermatozoal functions in in-vitrofertilization.Methods:We only included couples whose fertilization rate was 100%.A total of 82 cycles were included in our study.Before and after density gradient centrifugation,sperm morphology was evaluated by Diff-Quik stain according to the WHO criterion.The normal proportion of normal morphology spe...