精子DNA碎片化对体外受精和卵胞浆内单精子注射中正常反应型女性胚胎质量的影响。
Effect of Sperm DNA Fragmentation on Embryo Quality in Normal Responder Women in In Vitro Fertilization and Intracytoplasmic Sperm Injection.
作者信息
Kim Su Mi, Kim Seul Ki, Jee Byung Chul, Kim Seok Hyun
机构信息
Department of Obstetrics and Gynecology, Chungbuk National University Hospital, Cheongju, Korea.
Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Korea.
出版信息
Yonsei Med J. 2019 May;60(5):461-466. doi: 10.3349/ymj.2019.60.5.461.
PURPOSE
To investigate the associations between sperm DNA fragmentation (SDF) and embryo formation rate in normal responder women to in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI).
MATERIALS AND METHODS
Fifty-three consecutive, fresh IVF/ICSI cycles performed from 2014 to 2017 were selected. All women were normal responders (4 to 14 mature oocytes were retrieved) and at least one normally fertilized oocyte with two pronuclei was obtained in all cycles. Semen was collected on the day of oocyte retrieval, and SDF levels were measured by sperm chromatin dispersion test (Halosperm assay). At day 3 after insemination, embryo quality was evaluated by morphologic criteria and categorized as A/B/C/D. Top quality embryo were defined as grade A embryos with seven cells or more.
RESULTS
SDF levels showed a positive linear correlation with the male's age (r=0.307, =0.025) and a negative linear correlation with sperm motility (r=-0.491, <0.0001). To achieve top-quality or a grade A embryo formation rate >70%, the cut-off value SDF was <30.7% for each. Among individuals with SDF <30.7%, the median top-quality or grade A embryo formation rate was significantly higher than that among individuals with SDF ≥30.7% (38.1% vs. 20.0%, =0.038; 50% vs. 25.0%, =0.017).
CONCLUSION
In normal responder women, high SDF level resulted in low day 3 embryo formation rates. Our results suggest a paternal effect on embryo quality in IVF/ICSI cycles.
目的
探讨正常反应的体外受精/卵胞浆内单精子注射（IVF/ICSI）女性中精子DNA碎片率（SDF）与胚胎形成率之间的关联。
材料与方法
选取2014年至2017年连续进行的53个新鲜IVF/ICSI周期。所有女性均为正常反应者（取到4至14个成熟卵母细胞），且所有周期均至少获得一个有两个原核的正常受精卵母细胞。在取卵日收集精液，通过精子染色质扩散试验（Halosperm检测法）测量SDF水平。在受精后第3天，根据形态学标准评估胚胎质量并分为A/B/C/D级。优质胚胎定义为具有7个或更多细胞的A级胚胎。
结果
SDF水平与男性年龄呈正线性相关（r = 0.307，P = 0.025），与精子活力呈负线性相关（r = -0.491，P < 0.0001）。为达到优质或A级胚胎形成率>70%，每个的SDF临界值均<30.7%。在SDF<30.7%的个体中，优质或A级胚胎形成率的中位数显著高于SDF≥30.7%的个体（38.1%对20.0%，P = 0.038；50%对25.0%，P = 0.017）。
结论
在正常反应的女性中，高SDF水平导致第3天胚胎形成率较低。我们的结果提示在IVF/ICSI周期中父方因素对胚胎质量有影响。
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