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体外受精程序中凋亡精子的去除及其对妊娠率的影响。

The elimination of apoptotic sperm in IVF procedures and its effect on pregnancy rate.

作者信息

Merino-Ruiz Martha, Morales-Martínez Felipe Arturo, Navar-Vizcarra Edith, Valdés-Martínez Otto H, Sordia-Hernández Luis H, Saldívar-Rodríguez Donato, Vidal-Gutiérrez Oscar

机构信息

University Center for Reproductive Medicine, University Hospital "Dr. José Eleuterio González" of the UANL, Monterrey Nuevo León, México.

出版信息

JBRA Assist Reprod. 2019 Apr 30;23(2):112-116. doi: 10.5935/1518-0557.20190007.

Abstract

OBJECTIVE

To identify the effect of apoptotic sperm elimination with MACS in patients that require IVF.

METHODS

An experimental, cross-sectional, descriptive, prospective and non-blinded study of diagnostic tests performed in patients who required IVF and ICSI from July 2011 to July 2012. Ninety-two couples participated according to the treatment administered to the semen sample; in the control group: the samples were subjected only to density gradients before ICSI, in the study group: the same procedure was performed plus the addition of the MACS technique. Comparing the groups, we assessed the fertilization, division, viable embryos and clinical pregnancy rates in all cases.

RESULTS

We found significant differences when using MACS technique in sperm parameters. We found no differences between the total samples of the control and study groups. When separating the own and donated eggs in each group, we found an improvement in the fertilization rates (p<0.001) of the own eggs. In both groups, the handling of donated eggs lead to a significant improvement in the immunological pregnancy test (IPT) and fetal heart rate (FHR) results. Only in the donated eggs group, where MACS was applied, could we see that all cases with positive IPT had a fetal heart rate, which shows a significant difference (p<0.002) when compared with the control group, where the percentage decreased abruptly.

CONCLUSIONS

This study demonstrates the effectiveness of the use of annexins (MACS) in eliminating apoptotic sperm, and when the obtained sperm is applied to good-quality eggs.

摘要

目的

确定在需要体外受精(IVF)的患者中使用磁性激活细胞分选法(MACS)去除凋亡精子的效果。

方法

对2011年7月至2012年7月期间需要IVF和卵胞浆内单精子注射(ICSI)的患者进行的诊断测试进行一项实验性、横断面、描述性、前瞻性和非盲法研究。根据对精液样本的处理方式,92对夫妇参与了研究;在对照组中:样本在ICSI前仅进行密度梯度处理,在研究组中:进行相同的操作并加上MACS技术。比较两组,我们评估了所有病例的受精、分裂、存活胚胎和临床妊娠率。

结果

在精子参数方面使用MACS技术时我们发现了显著差异。我们发现对照组和研究组的总样本之间没有差异。当在每组中分离自身卵子和捐赠卵子时,我们发现自身卵子的受精率有所提高(p<0.001)。在两组中,对捐赠卵子的处理导致免疫妊娠试验(IPT)和胎儿心率(FHR)结果有显著改善。仅在应用MACS的捐赠卵子组中,我们可以看到所有IPT呈阳性的病例都有胎儿心率,与对照组相比显示出显著差异(p<0.002),对照组的百分比急剧下降。

结论

本研究证明了使用膜联蛋白(MACS)去除凋亡精子的有效性,以及当获得的精子应用于优质卵子时的有效性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7010/6501751/1b1b48532ddb/jbra-23-02-0112-g01.jpg

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