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[磁激活细胞分选法(MACS)与密度梯度离心法(DGC)在辅助生殖技术中用于人类精子筛选的比较]

[Magnetic-activated cell sorting (MACS) versus density gradient centrifugation (DGC) for the selection of human sperm in assisted reproductive techniques].

作者信息

Fang L, Ye Y H, Li E S, Feng G F

机构信息

Department of Reproductive Endocrinology, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou 310000, China.

出版信息

Zhonghua Yi Xue Za Zhi. 2018 Oct 30;98(40):3263-3267. doi: 10.3760/cma.j.issn.0376-2491.2018.40.010.

Abstract

To investigate whether the assisted reproductive techniques (ART) outcomes can be improved by using magnetic-activated cell sorting combined isolate density gradient centrifugation (MACS-DGC), and to compare the results with the conventional isolate density gradient centrifugation (DGC) method. In the period from January to December 2014, patients who attended the andrology laboratory for sperm DNA fragmentation analysis and underwent the fertilization and embryo transfer (IVF-ET) treatment were divided into 3 groups, and each group has two subgroups according to the way of fertilization : in vitro fertilization (IVF) as subgroup 1 and intracytoplasmic sperm injection (ICSI) as subgroup 2. Group A (A1, A2 ): DNA fragmentation index(DFI)≥20 and using MACs; Group B (B1, B2): DFI≥20 and using isolate method; Group C (C1, C2): DFI<20 and using isolate method. The fertilization rate, good-quality embryos, implantation rate, pregnancy rate and live-birth rate of each group were analyzed. Similar results were obtained among groups for all the parameters compared: On IVF cycles no significant difference was observed in fertilization rate, percentage of good-quality embryos on day 3, implantation rate, positive beta-hCG tests, and live-birth rate among the three subgroups (A1 vs B1 vs C1). Between the subgroups of ICSI cycles (A2 vs B2 vs C2) the percentage of high-quality embryos, pregnancy rate, implantation rate and live-birth rate were all significantly higher in the MACS-DGC (A2) group compared to DGC alone (B2). Based on the results, MACS as a part of sperm preparation technique will not improve sperm fertilizing potential, embryos quality, implantation rate, pregnancy rate or live-birth rate of IVF, but it may help select the most fertile sperm and to improve clinical outcomes of ICSI.

摘要

为研究采用磁激活细胞分选联合密度梯度离心法(MACS-DGC)是否能改善辅助生殖技术(ART)的结局,并将结果与传统的密度梯度离心法(DGC)进行比较。2014年1月至12月期间,到男科实验室进行精子DNA碎片分析并接受体外受精和胚胎移植(IVF-ET)治疗的患者被分为3组,根据受精方式每组又分为两个亚组:体外受精(IVF)为亚组1,卵胞浆内单精子注射(ICSI)为亚组2。A组(A1、A2):DNA碎片指数(DFI)≥20且采用MACS法;B组(B1、B2):DFI≥20且采用传统方法;C组(C1、C2):DFI<20且采用传统方法。分析了每组的受精率、优质胚胎率、着床率、妊娠率和活产率。比较的所有参数在各组间均得到相似结果:在IVF周期中,三个亚组(A1 vs B1 vs C1)的受精率、第3天优质胚胎百分比、着床率、β-hCG检测阳性率和活产率均无显著差异。在ICSI周期的亚组间(A2 vs B2 vs C2),与单纯DGC组(B2)相比,MACS-DGC组(A2)的高质量胚胎百分比、妊娠率、着床率和活产率均显著更高。根据结果,MACS作为精子处理技术的一部分不会提高IVF的精子受精潜能、胚胎质量、着床率、妊娠率或活产率,但可能有助于筛选出最具受精能力的精子并改善ICSI的临床结局。

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