Obstetrics and Gynaecology Department, IRCCS Ospedale San Raffaele, Milan, Italy.
Division of Genetics and Cell Biology, Reproductive Sciences Laboratory, IRCCS Ospedale San Raffaele, Via Olgettina 58, 20132, Milan, Italy.
J Assist Reprod Genet. 2018 Oct;35(10):1897-1903. doi: 10.1007/s10815-018-1256-8. Epub 2018 Jul 11.
To investigate the effect of sperm concentration, motility and advanced paternal age on reproductive outcomes.
A retrospective analysis of 1266 intracytoplasmic sperm injection (ICSI) cycles between 2013 and 2017. The cohort was divided into four groups according to semen concentration based on the WHO criteria (2010): group A (conc. <1 M/ml), group B (1 ≤ conc. <5 M/ml), group C (5 ≤ conc. < 15 M/ml) and the control group D (conc. ≥15 M/ml). The primary outcome investigated was the blastulation rate. Secondary outcomes were fertilization rate, top quality blastocyst formation rate and ongoing pregnancy rate.
After adjustment for maternal age and number of oocytes recovered, a significant difference was observed between group A and group D on the rate of fertilized oocytes [66.7 (40.0-80.0) vs 75.0 (57.1-90.2), adjusted p < 0.001] and the blastocyst formation rate [50.0 (33.3-66.3) vs 55.6 (40.0-75.0), adjusted p < 0.05]. However, the male factor did not affect the top quality blastocyst formation rate nor the ongoing pregnancy rate. Considering the age of the male partner as confounding factor, at the increase of each year of age, a reduction of 0.3% on the fertilization rate was observed but no other outcome was impacted. A negative correlation was also observed between sperm motility and fertilization rate in the group with a motility <5%.
Male factor infertility and advanced paternal age may compromise fertilization and blastulation rates but not top quality blastocyst formation rate or the establishment of pregnancy in ICSI cycles.
研究精子浓度、活力和准父亲年龄对生殖结局的影响。
对 2013 年至 2017 年期间的 1266 例卵胞浆内单精子注射（ICSI）周期进行回顾性分析。根据世界卫生组织（WHO）2010 年标准，将队列分为四组：A 组（浓度<1×10^6/ml）、B 组（1×10^6/ml≤浓度<5×10^6/ml）、C 组（5×10^6/ml≤浓度<15×10^6/ml）和对照组 D（浓度≥15×10^6/ml）。主要观察指标是囊胚形成率。次要观察指标是受精率、优质囊胚形成率和持续妊娠率。
调整母体年龄和获得卵母细胞数后，A 组与 D 组的受精率[66.7（40.0-80.0）比 75.0（57.1-90.2），调整后 p<0.001]和囊胚形成率[50.0（33.3-66.3）比 55.6（40.0-75.0），调整后 p<0.05]存在显著差异。然而，男性因素并不影响优质囊胚形成率或持续妊娠率。考虑到准父亲的年龄是混杂因素，每增加 1 岁，受精率降低 0.3%，但其他结果不受影响。在精子活力<5%的组中，还观察到精子活力与受精率呈负相关。
男性因素不孕和准父亲年龄可能会降低受精率和囊胚形成率，但不会影响 ICSI 周期的优质囊胚形成率或妊娠的建立。
