[精子DNA碎片对体外受精-胚胎移植中冻融囊胚移植结局的影响]

[Impact of sperm DNA fragmentation on the outcome of frozen-thawed blastocyst transfer in in vitro fertilization and embryo transfer].

作者信息

Li Huan, Deng Hao, Zhao Jun, Zhong Yu-Cheng, Zhu Li, Wu Ya-Qin, Ma Wen-Min

机构信息

Center of Reproductive Medicine, Foshan Maternal and Child Care Hospital, Southern Medical University, Foshan, Guangdong 528000, China.

出版信息

Zhonghua Nan Ke Xue. 2020 May;26(5):422-426.

PMID:33354950

Abstract

OBJECTIVE

To study the impact of sperm DNA fragmentation (DF) on the outcome of frozen-thawed blastocyst transfer in in vitro fertilization and embryo transfer (IVF-ET).

METHODS

We retrospectively analyzed 308 cases of routine IVF-ET performed at our Center of Reproductive Medicine from January 2016 to January 2018. According to the sperm DNA fragmentation index (DFI), we divided the patients into a normal DFI (DFI ≤ 15%, n = 114), a moderate DFI (15% < DFI ≤ 30%, n = 103), and a high DFI group (DFI > 30 %, n = 91), and compared the development of embryos and clinical outcomes among the three groups.

RESULTS

The blastocyst formation rate was remarkably higher in the normal and moderate DFI groups than in the high DFI group (68.9% and 66.2% vs 58.3%, P < 0.05) but the percentage of available blastocysts exhibited no statistically significant difference between the former two and the latter group (88.1% and 84.0% vs 81.2%, P > 0.05). There were statistically significant differences among the normal, moderate and high DFI groups in the percentage of high-quality blastocysts (80.3% vs 68.8% vs 59.7%, P < 0.05). The implantation rate was dramatically lower in the high DFI group than in the normal and moderate DFI groups (30.4% vs 43.1% and 41.0%, P < 0.05), and so was the clinical pregnancy rate (33.6% vs 43.2% and 40.2%, P < 0.05), but the abortion rate markedly higher in the former than in the latter two groups (16.2% vs 10.0% and 9.8%, P < 0.05).

CONCLUSIONS

High sperm DFI can not only significantly reduce the rates of blastocyst formation, available blastocysts and high-quality blastocysts, but also decrease the rates of implantation and clinical pregnancy and increase that of abortion after frozen-thawed blastocyst transfer.

摘要

目的

探讨精子DNA碎片率（DF）对体外受精-胚胎移植（IVF-ET）冻融囊胚移植结局的影响。

方法

回顾性分析2016年1月至2018年1月在本生殖医学中心进行的308例常规IVF-ET病例。根据精子DNA碎片指数（DFI），将患者分为正常DFI组（DFI≤15%，n = 114）、中度DFI组（15%＜DFI≤30%，n = 103）和高度DFI组（DFI＞30%，n = 91），比较三组胚胎发育情况及临床结局。

结果

正常DFI组和中度DFI组的囊胚形成率显著高于高度DFI组（68.9%和66.2% vs 58.3%，P＜0.05），但前两组与后一组之间可用囊胚的比例无统计学显著差异（88.1%和84.0% vs 81.2%，P＞0.05）。正常、中度和高度DFI组之间优质囊胚的比例有统计学显著差异（80.3% vs 68.8% vs 59.7%，P＜0.05）。高度DFI组的着床率显著低于正常DFI组和中度DFI组（30.4% vs 43.1%和41.0%，P＜0.05），临床妊娠率也是如此（33.6% vs 43.2%和40.2%，P＜0.05），但前一组的流产率明显高于后两组（16.2% vs 10.0%和9.8%，P＜0.05）。