Frydman Nelly, Prisant Nadia, Hesters Laetitia, Frydman René, Tachdjian Gérard, Cohen-Bacrie Paul, Fanchin Rénato
Department of Genetics and Reproduction, Antoine Béclère Hospital, Clamart, France.
Fertil Steril. 2008 Jan;89(1):92-7. doi: 10.1016/j.fertnstert.2007.02.022. Epub 2007 May 4.
Potential reparation of sperm DNA fragmentation in the oocyte may disturb any relationship between DNA-damaged sperm and the implantation ability of resulting embryos. To rule out this factor, we analyzed the consequences of sperm DNA fragmentation on IVF-ET outcome in women with healthy ovarian function.
Prospective study.
Teaching hospital, France.
PATIENT(S): All 117 women were <38 years old, who combined normal serum day-3 FSH and inhibin B levels with an adequate response to controlled ovarian hyperstimulation.
INTERVENTION(S): The DNA fragmentation rate was determined in the raw sperm used for conventional IVF by flow cytometric terminal deoxynucleotidyl transferase-mediated dUTP nick-end labeling assay. Cycles were sorted into two groups according to whether DNA fragmentation exceeded (high fragmentation [HF], n = 52) or did not exceed (low fragmentation [LF], n = 65) the 50th percentile of values (35%).
MAIN OUTCOME MEASURE(S): D2 embryo quality and implantation and ongoing pregnancy rates.
RESULT(S): Patients' characteristics, raw semen parameters, fertilization rates, and embryology data were similar in HF and LF groups. Clinical (37.5% vs. 62.5%) and ongoing (23.5% vs. 57.8%) pregnancy rates per ET and implantation rates (24.5% vs. 42.4%) were lower in the HF group than in the LF group.
CONCLUSION(S): High sperm DNA fragmentation spares fertilization and top embryo morphology rates but is associated with decreased IVF-ET outcome.
卵母细胞中精子DNA片段化的潜在修复可能会干扰DNA受损精子与所得胚胎着床能力之间的任何关系。为排除这一因素，我们分析了精子DNA片段化对卵巢功能正常女性体外受精-胚胎移植（IVF-ET）结局的影响。
前瞻性研究。
法国教学医院。
所有117名女性年龄均<38岁，她们血清第3天卵泡刺激素（FSH）和抑制素B水平正常，对控制性卵巢过度刺激反应良好。
通过流式细胞术末端脱氧核苷酸转移酶介导的dUTP缺口末端标记法，测定用于常规IVF的未处理精子中的DNA片段化率。根据DNA片段化率是否超过第50百分位数（35%），将周期分为两组，即DNA片段化率超过该值的为高片段化组（HF，n = 52），未超过的为低片段化组（LF，n = 65）。
D2胚胎质量、着床率和持续妊娠率。
HF组和LF组患者的特征、未处理精液参数、受精率和胚胎学数据相似。HF组每次ET的临床妊娠率（37.5%对62.5%）、持续妊娠率（23.5%对57.8%）和着床率（24.5%对42.4%）均低于LF组。
高精子DNA片段化对受精和优质胚胎形态率无影响，但与IVF-ET结局降低有关。
