Luo Qiang-Xiang, Liao Yong-Bin, Huang Chang-Ping, Guo Jiang-Hua, Liang Xiao-Dong
Center of Reproductive Medicine, Jiangmen Hospital of Sun Yat-sen University, Jiangmen, Guangdong 529000, China.
Jiangmen Research Institute of Urology and Reproduction, Jiangmen Hospital of Sun Yat-sen University, Jiangmen, Guangdong 529000, China.
Zhonghua Nan Ke Xue. 2020 Aug;26(8):708-712.
To explore the correlation of the sperm DNA fragmentation index (DFI) with age and other semen parameters in infertile men and its influence on the outcomes of in vitro fertilization and embryo transplantation (IVF-ET).
Semen samples were obtained from 6 162 infertile males in our hospital between July 2017 and December 2018. Sperm concentration, the percentages of progressively motile sperm (PMS) and morphologically normal sperm (MNS) and sperm DFI were determined by computer-assisted semen analysis, modified Papanicolaou staining and sperm chromatin structure assay, respectively. According to the sperm DFI, the samples were divided into three groups: DFI≤15%, 15%<DFI<30%, and DFI≥30%, followed by analysis of the correlation of sperm DFI with age and other semen parameters. The clinical data were also collected from 1 206 couples undergoing IVF-ET between January 2015 and December 2018, who fell into four DFI groups: DFI≤10%, 10%<DFI≤20%, 20%<DFI≤30%), and DFI>30%. Comparisons were made among different groups in the rates of fertilization, embryo cleavage, embryo formation and pregnancy.
Spearman correlation analysis showed that DFI was correlated positively with age (r = 0.508, P < 0.05), but negatively with sperm concentration (r = －0.155, P < 0.05) and the percentages of PMS (r = －0.111, P < 0.05) and MNS (r = －0.315, P < 0.05). With sperm DFI >20%, the clinical pregnancy rate of IVF-ET was significantly reduced, while with sperm DFI >30%, the rate of available embryos markedly decreased and that of biochemical pregnancy remarkably increased. No correlation was found between sperm DFI and the rates of fertilization, embryo cleavage and high-quality embryos in IVF-ET.
In infertile males, sperm DFI is correlated positively with age but negatively with sperm concentration and the percentages of PMS and MNS, and it significantly affects the outcomes of IVF-ET.
探讨男性不育患者精子DNA碎片指数（DFI）与年龄及其他精液参数的相关性，及其对体外受精-胚胎移植（IVF-ET）结局的影响。
收集2017年7月至2018年12月在我院就诊的6162例男性不育患者的精液样本。分别采用计算机辅助精液分析、改良巴氏染色法及精子染色质结构分析技术，检测精子浓度、前向运动精子（PMS）百分率、形态正常精子（MNS）百分率及精子DFI。根据精子DFI将样本分为三组：DFI≤15%、15%＜DFI＜30%、DFI≥30%，分析精子DFI与年龄及其他精液参数的相关性。收集2015年1月至2018年12月行IVF-ET的1206对夫妇的临床资料，将其分为四个DFI组：DFI≤10%、10%＜DFI≤20%、20%＜DFI≤30%、DFI＞30%。比较不同组间的受精率、胚胎卵裂率、胚胎形成率及妊娠率。
Spearman相关性分析显示，DFI与年龄呈正相关（r = 0.508，P ＜0.05），与精子浓度（r = －0.155，P ＜0.05）、PMS百分率（r = －0.111，P ＜0.05）及MNS百分率（r = －0.315，P ＜0.05）呈负相关。当精子DFI＞20%时，IVF-ET临床妊娠率显著降低；当精子DFI＞30%时，可利用胚胎率明显下降，生化妊娠率显著升高。精子DFI与IVF-ET的受精率、胚胎卵裂率及优质胚胎率无相关性。
在男性不育患者中，精子DFI与年龄呈正相关，与精子浓度、PMS百分率及MNS百分率呈负相关，且对IVF-ET结局有显著影响。
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