梗阻性无精子症患者精子顶体完整性与卵胞质单精子注射治疗结局之间的关系

目的:探讨梗阻性无精子症(OA)患者精子的顶体完整性及其与卵胞质单精子注射(ICSI)治疗临床结局之间的关系。方法:选取梗阻性无精子症患者共37例为试验组,同期进行体外受精治疗且精液常规参数正常的男性33例为对照组,应用荧光标记的豌豆凝集素法(PSA-FITC)检测精子顶体完整性,巴氏染色法分析精子形态,比较试验组与对照组的顶体完整率(AIR)、正常形态率(NFR)、受精率(FR)、卵裂率(CR)及优质胚胎率(OER),并将AIR与FR、NFR与FR进行相关性分析。结果:试验组的AIR、NFR、FR显著低于对照组(P<0.01),CR、OER试验组与对照组相比无统计学差异(P>0.05)。试验组AIR与FR呈显著正相关(r=0.595,P<0.01),NFR与FR显著正相关(r=0.463,P<0.01);对照组AIR与FR显著正相关(r=0.683,P<0.01),NFR与FR呈显著正相关(r=0.205,P<0.01)。结论:梗阻性无精子症患者的精子AIR较低。行皮下附睾抽吸术(PESA)-ICSI的梗阻性无精子症患者精子其AIR高则受精率也会高。

Evaluation of Sperm Acrosome Integrity with Clinical Outcome after Intracytoplasmic Sperm Injection in Patients with Obstructive Azoospermia

Objective: To evaluate the correlation between sperm acrosome integrity(AI) and fertilization rate after intracytoplasmic sperm injection(ICSI) of samples from patients with obstructive azoospermia.Methods: Thirty-seven obstructive azoospermia patients who receiced percutaneous epididymal sperm apiration(PESA) undergoing ICSI were enrolled as test gruop and 33 semen samples from age-matched normospermic males were set as the control.These samples were assessed by AI and normal forms(NF).Acrosome integrity was detected by fluorescein-labeled pisum sativum agglutinin(PSA-FITC).Clinical outcomes in terms of fertilization rate(FR),cleavage rate(CR) and optimal embryo rate(OER) were evaluated concomitantly.Correlation analysis was assessed between AI rate(AIR) and FR in obstructive azoospermia group and control group respectively.The same analysis was evaluated between NF rate(NFR) and FR.Results: AIR,NFR and FR of test group were significantly lower than those of the control(P<0.01).However,CR and OER showed no difference between test group and the control(P>0.05).In addition,a positive correlation was found between AIR and FR(r=0.595,P<0.01) in the obstructive azoospermia group.Furthermore,a similar result was achieved between NFR and FR(r=0.463,P<0.01).In the control,meanwhile,AIR was positively correlated with FR(r=0.683,P<0.01).Moreover,a positive correlation was expected between NFR and FR(r=0.205,P<0.01).Conclusion: Males with obstructive azoospermia have poor AIR.When undergoing PESA-ICSI,these patients would obtain low FR.Epididymal sperm samples with high AIR could result in high FR while going through ICSI.