Moubasher Alaa El Din-Abdel Aal, Taha Emad Abdelrehim, Elnashar Ehab Mohamed, Abdel Maged Ahmed Abdel Aal, Zahran Asmaa Mohamed, Sayed Heba Hassan, Gaber Hisham Diab
Department of Dermatology, Venereology and Andrology, Faculty of Medicine, Assiut University, Assiut, Egypt.
Department of Obstetrics and Gynecology, Faculty of Medicine, Assiut University, Assiut, Egypt.
Clin Exp Reprod Med. 2021 Mar;48(1):61-68. doi: 10.5653/cerm.2020.03965. Epub 2021 Feb 17.
This study was conducted to investigate the relationship of semen parameters in samples used for intracytoplasmic sperm injection (ICSI) with fertilization and pregnancy rates in infertile couples.
In this prospective study of Infertile couples with male factor infertility that had undergone ICSI, fractions of the same semen samples obtained for microinjection (to ensure the best predictability) were evaluated to determine the semen parameters and sperm DNA fragmentation index (DFI) on the day of oocyte recovery.
In total, 120 couples completed the study and were subdivided into fertilized (n=87) and non-fertilized couples (n=33). The fertilized couples were further classified into pregnant (n=48) and non-pregnant (n=39) couples. Compared to non-fertilized and non-pregnant couples, fertilized and pregnant couples showed statistically significantly higher sperm viability and percentage of normal sperm morphology, as well as significantly lower sperm DFI values. A receiver operating characteristic curve analysis of data from the 120 ICSI cycles showed that sperm viability, normal sperm morphology percentages, and sperm DFI were significant prognostic indicators of fertilization at cutoff values of 40%, 7%, and 46%, respectively. A sperm DFI of 46% showed sensitivity and specificity of 95% and 90%, respectively, for predicting fertilization, and no clinical pregnancies occurred in couples with a sperm DFI above 46%.
Semen parameters from the ICSI day sample, especially sperm viability, normal morphology, and DFI, had an impact on fertilization and pregnancy outcomes in ICSI cycles.
本研究旨在探讨用于卵胞浆内单精子注射（ICSI）的样本中精液参数与不育夫妇受精率和妊娠率之间的关系。
在这项针对患有男性因素不育的不育夫妇进行的前瞻性研究中，对为显微注射获取的同一份精液样本的不同部分（以确保最佳可预测性）进行评估，以确定卵母细胞回收当天的精液参数和精子DNA碎片指数（DFI）。
共有120对夫妇完成了研究，并被分为受精夫妇（n = 87）和未受精夫妇（n = 33）。受精夫妇进一步分为妊娠夫妇（n = 48）和未妊娠夫妇（n = 39）。与未受精和未妊娠夫妇相比，受精和妊娠夫妇的精子活力、正常精子形态百分比在统计学上显著更高，而精子DFI值则显著更低。对120个ICSI周期的数据进行的受试者工作特征曲线分析表明，精子活力、正常精子形态百分比和精子DFI分别在临界值为40%、7%和46%时是受精的显著预后指标。精子DFI为46%时，预测受精的敏感性和特异性分别为95%和90%，精子DFI高于46%的夫妇未发生临床妊娠。
ICSI当天样本的精液参数，尤其是精子活力、正常形态和DFI，对ICSI周期的受精和妊娠结局有影响。
