男性睡眠质量与前往生殖医学门诊的夫妇辅助生殖技术结局：一项中国队列研究。
Men's Sleep Quality and Assisted Reproductive Technology Outcomes in Couples Referred to a Fertility Clinic: A Chinese Cohort Study.
作者信息
Du Cong-Qi, Zhang Dong-Xue, Chen Jing, He Qiu-Fen, Lin Wen-Qin
机构信息
Reproductive Medicine Center, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, People's Republic of China.
Department of Embryo Laboratory, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, People's Republic of China.
出版信息
Nat Sci Sleep. 2022 Apr 2;14:557-566. doi: 10.2147/NSS.S353131. eCollection 2022.
BACKGROUND
Poor sleep quality has been linked to lower semen quality, but it is unclear whether this result in decreased fertility. To address this question, we retrospectively evaluated the relationship between men's sleep quality and treatment outcomes in subfertile couples receiving assisted reproductive technology (ART).
PATIENT ENROLLMENT AND METHODS
From September 2017 to November 2019, 282 subfertile couples referred to a Chinese fertility clinic and eligible for ART procedures were enrolled in our study. Sociodemographic characteristics, life habits, and sleep habits in the year prior to ART were recorded. Sleep quality was measured using the Pittsburgh Sleep Quality Index (PSQI). We first divided the patients into two groups based on sleep quality (good sleep: PSQI < 5 and poor sleep: PSQI ≥ 5). Then, the ART outcomes (fertilization rate, good quality embryo rate, implantation rate, positive pregnancy rate, clinical pregnancy rate, live birth rate, miscarriage rate, and birth weight) of each group were analyzed. Finally, multivariate linear and logistic regression analysis were used to examine the relationship between sleep quality (discrete variable or dichotomous variable) and ART outcomes.
RESULTS
The participants in the poor sleep group showed a lower fertilization rate of 60.13% (543/903) when compared with 67.36% for the good sleep group (902/1339), < 0.001. The global PSQI score had a significant influence on birth weight (β, -63.81; 95% CI, -119.91- -8.52; = 0.047), and live birth rate (OR, 0.88; 95% CI, 0.78- 0.99; = 0.047) after adjusting for the interfering factors. Men's sleep quality was unrelated to good quality embryos rate, implantation rate, positive pregnancy rate, clinical pregnancy rate, or miscarriage rate.
CONCLUSION
Men's sleep quality was positively associated with fertilization rate, birth weight, and live birth rate among couples undergoing ART.
背景
睡眠质量差与精液质量较低有关，但尚不清楚这是否会导致生育能力下降。为了解决这个问题，我们回顾性评估了接受辅助生殖技术（ART）的不育夫妇中男性睡眠质量与治疗结局之间的关系。
患者招募与方法
2017年9月至2019年11月，282对转诊至中国一家生育诊所且符合ART程序条件的不育夫妇纳入我们的研究。记录ART前一年的社会人口统计学特征、生活习惯和睡眠习惯。使用匹兹堡睡眠质量指数（PSQI）测量睡眠质量。我们首先根据睡眠质量将患者分为两组（良好睡眠：PSQI<5；睡眠不佳：PSQI≥5）。然后，分析每组的ART结局（受精率、优质胚胎率、着床率、妊娠阳性率、临床妊娠率、活产率、流产率和出生体重）。最后，采用多变量线性和逻辑回归分析来检验睡眠质量（离散变量或二分变量）与ART结局之间的关系。
结果
睡眠不佳组的参与者受精率为60.13%（543/903），而良好睡眠组为67.36%（902/1339），<0.001。在调整干扰因素后，全球PSQI评分对出生体重（β，-63.81；95%CI，-119.91--8.52；=0.047）和活产率（OR，0.88；95%CI，0.78-0.99；=0.047）有显著影响。男性睡眠质量与优质胚胎率、着床率、妊娠阳性率、临床妊娠率或流产率无关。
结论
在接受ART的夫妇中，男性睡眠质量与受精率、出生体重和活产率呈正相关。
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