Center of Reproductive Medicine, the Affiliated Hospital of Nantong University, Nantong 226001, China.
Asian J Androl. 2022 Jan-Feb;24(1):109-115. doi: 10.4103/aja.aja_17_21.
Damage to sperm DNA was proposed to play an important role in embryonic development. Previous studies focused on outcomes after fresh embryo transfer, whereas this study investigated the influence of sperm DNA fragmentation index (DFI) on laboratory and clinical outcomes after frozen embryo transfer (FET). This retrospective study examined 381 couples using cleavage-stage FET. Sperm used for intracytoplasmic sperm injection (ICSI) or in vitro fertilization (IVF) underwent density gradient centrifugation and swim up processing. Sperm DFI had a negative correlation with sperm motility (r = -0.640, P < 0.01), sperm concentration (r = -0.289, P < 0.01), and fertilization rate of IVF cycles (r = -0.247, P < 0.01). Sperm DFI examined before and after density gradient centrifugation/swim up processing was markedly decreased after processing (17.1% vs 2.4%, P < 0.01; 65 randomly picked couples). Sperm progressive motility was significantly reduced in high DFI group compared with low DFI group for both IVF and ICSI (IVF: 46.9% ± 12.4% vs 38.5% ± 12.6%, respectively; ICSI: 37.6% ± 14.1% vs 22.3% ± 17.8%, respectively; both P < 0.01). The fertilization rate was significantly lower in high ( ≥25%) DFI group compared with low (<25%) DFI group using IVF (73.3% ± 23.9% vs 53.2% ± 33.6%, respectively; P < 0.01) but was equivalent in high and low DFI groups using ICSI. Embryonic development and clinical outcomes after FET were equivalent for low and high DFI groups using ICSI or IVF. In this study, sperm DFI did not provide sufficient information regarding embryo development or clinical outcomes for infertile couples using FET.
精子 DNA 损伤被认为在胚胎发育中发挥重要作用。先前的研究集中在新鲜胚胎移植后的结果上，而本研究调查了精子 DNA 碎片化指数（DFI）对冷冻胚胎移植（FET）后的实验室和临床结果的影响。这项回顾性研究检查了 381 对接受卵裂期 FET 的夫妇。用于胞浆内单精子注射（ICSI）或体外受精（IVF）的精子经过密度梯度离心和游动处理。精子 DFI 与精子活力呈负相关（r = -0.640，P < 0.01），与精子浓度（r = -0.289，P < 0.01）和 IVF 周期的受精率（r = -0.247，P < 0.01）。在密度梯度离心/游动处理前后检查的精子 DFI 在处理后明显降低（17.1%对 2.4%，P < 0.01；65 对随机挑选的夫妇）。DFI 较高组的精子向前运动与 DFI 较低组相比，在 IVF 和 ICSI 中均显著降低（IVF：46.9% ± 12.4%对 38.5% ± 12.6%，分别；ICSI：37.6% ± 14.1%对 22.3% ± 17.8%，分别；均 P < 0.01）。DFI 较高组（≥25%）的受精率明显低于 DFI 较低组（<25%）使用 IVF（73.3% ± 23.9%对 53.2% ± 33.6%，分别；P < 0.01），但在使用 ICSI 时，高和低 DFI 组之间没有差异。在使用 ICSI 或 IVF 的情况下，低 DFI 组和高 DFI 组的胚胎发育和 FET 后的临床结局相当。在这项研究中，精子 DFI 并没有为使用 FET 的不孕夫妇提供关于胚胎发育或临床结局的足够信息。
