对预处理和后处理精子参数进行综合评估，以预测使用丈夫精子进行宫腔内人工授精后的成功妊娠率。

A comprehensive evaluation of pre- and post-processing sperm parameters for predicting successful pregnancy rate following intrauterine insemination with the husband's sperms.

机构信息

Department of Obstetrics and Gynecology, Key Laboratory for Major Obstetric Diseases of Guangdong Province, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510150, China.

Key Laboratory of Reproduction and Genetics of Guangdong Higher Education Institutes, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510150, China.

出版信息

BMC Pregnancy Childbirth. 2022 Sep 12;22(1):703. doi: 10.1186/s12884-022-05029-8.

DOI:10.1186/s12884-022-05029-8

PMID:36096780

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9469606/

Abstract

BACKGROUND

To determine the predictive values of sperm parameters pre- and post-processing by density gradient centrifugation for clinical pregnancy rates (CPRs) following artificial insemination by husband (AIH) in infertile Chinese couples.

METHODS

A total of 3,522 AIH cycles from 1,918 couples were retrospectively analyzed. The parameters were compared between the pregnant and non-pregnant groups and further between different etiological groups (Male-factor, Both-male-and-female-factor, and Other-factor). Multivariate logistic regression analysis was performed to create models for predicting the CPRs of each etiological group.

RESULTS

The overall CPR was 13.3%. There were significant improvements for most sperm parameters after DGC. Multivariate logistic regression analysis indicated that, in overall AIH cases, the top parameters significantly influencing the CPR of AIH were pre-STR (OR = 1.037; P = 0.048) and post-VSL (OR = 1.036; P = 0.011). In the Male-factor Group, the top influencing parameters were pre-VCL (OR = 2.096; P = 0.008), pre-LIN (OR = 1.930; P = 0.002) and post-VSL (OR = 1.316; P = 0.023). In the Both-factor Group, the top influencing parameters were pre-VCL (OR = 1.451; P = 0.008) and post-motility (OR = 1.218; P = 0.049). In the Other-factor Group, the top influencing parameters were pre-VAP (OR = 1.715; P = 0.024), pre-STR (OR = 1.20; P = 0.011) and post-VSL (OR = 1.04; P = 0.017). Moreover, receiver operating characteristic analysis showed that the logistic regression models of the Male- and Both-factor Groups had greater powers for prognostic classification than those of other groups.

CONCLUSIONS

This study demonstrated that some sperm parameters have a collinearity relationship in predicting the CPR following AIH. Moreover, the predictive capacity of a multivariate logistic regression model is better than those of individual parameters, especially for the Male- and Both-factor Groups. In these cases, pre-VCL is the common top influencing factor.

摘要

背景

为了确定密度梯度离心法（DGC）预处理和后处理精子参数对不孕夫妇夫精人工授精（AIH）后临床妊娠率（CPR）的预测价值。

方法

回顾性分析了 1918 对夫妇的 3522 个 AIH 周期。比较了妊娠组和非妊娠组以及不同病因组（男性因素、男女双方因素和其他因素）之间的参数。采用多变量逻辑回归分析建立每个病因组 CPR 的预测模型。

结果

总 CPR 为 13.3%。DGC 后大多数精子参数均有显著改善。多变量逻辑回归分析表明，在整体 AIH 病例中，对 AIH CPR 有显著影响的前向运动精子总数（STR）参数（OR=1.037；P=0.048）和后向运动精子速度（VSL）参数（OR=1.036；P=0.011）。在男性因素组中，影响最大的参数是前向运动精子平均路径速度（VCL）参数（OR=2.096；P=0.008）、前向直线性（LIN）参数（OR=1.930；P=0.002）和后 VSL 参数（OR=1.316；P=0.023）。在男女双方因素组中，影响最大的参数是前向运动精子 VCL 参数（OR=1.451；P=0.008）和后向运动精子活力（OR=1.218；P=0.049）。在其他因素组中，影响最大的参数是前向非前向运动精子（VAP）参数（OR=1.715；P=0.024）、前 STR 参数（OR=1.20；P=0.011）和后 VSL 参数（OR=1.04；P=0.017）。此外，接受者操作特征分析显示，男性和男女双方因素组的逻辑回归模型在预测 AIH 后 CPR 方面的分类能力强于其他组。