精子DNA碎片指数阈值与体外受精-胚胎移植结局的相关性研究

目的研究不同的精子DNA碎片率(SDF)阈值水平与IVF-ET结局的关系。方法对纳入病例的临床资料进行回顾性分析,并将10%、20%和30%分别作为SDF阈值进行分组,以比较不同SDF阈值水平下精液常规参数、顶体酶活力以及IVF-ET生殖结局的差异。结果在不同SDF阈值(10%、20%或30%)水平下,SDF高低组之间的精液常规各项参数、顶体酶活力均无统计学差异(P0.05)。SDF阈值设为10%时,SDF高低组之间的IVF-ET结局无统计学差异(P0.05);SDF阈值设为20%或30%时,高SDF组患者的优质胚胎率、临床妊娠率均低于低SDF组,差异有统计学意义(P0.05);SDF阈值设为30%时,高SDF组患者的受精率也低于低SDF组,差异有统计学意义(P0.05)。结论当精子SDF20%时,可能对患者的辅助生殖结局产生负面影响,建议给予适当的抗氧化治疗,待患者的精子SDF≤20%时,再进入IVFET助孕周期。

Impact of threshold value of sperm DNA fragmentation on IVF-ET outcome

Objective: To evaluate the correlation between the threshold value of sperm DNA fragment (SDF) and IVF-ET outcome. Methods: The clinical data were retrospectively analyzed. The patients were divided into three groups according to the set threshold value of SDF (10%,20% and 30%,respectively). Differences in semen routine parameters,acrosin activity,and IVF-ET outcome were compared among the three groups. Results: There was no significantly difference in semen routine parameters and acrosin activity among the three groups with the different SDF threshold value (10%,20% or 30%) (P>0.05). When SDF threshold value was set as 10%,there were no significantly differences in high quality embryo rate and clinical pregnant rate of IVF-ET between higher SDF group and lower SDF group (P>0.05). When the SDF threshold value was set as 20% or 30%,high-quality embryo rate and clinical pregnancy rate in higher SDF group were significantly lower than that in lower SDF group (P<0.05). The fertilization rate was also significantly decreased in higher SDF group when the threshold value was set as 30% (P<0.05). Conclusions: When the SDF threshold value was more than 20%,the higher SDF may have a negative impact on the assisted reproductive outcome of the patients. It is recommended to give appropriate anti-oxidative therapy. When the patient's sperm SDF is decreased to ≤20% after treatment,and then enters the IVF-ET cycle.