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精子 DNA 碎片化对辅助生殖技术临床结局的影响:对过去五年的系统回顾。

Impact of sperm DNA fragmentation on the clinical outcome of assisted reproduction techniques: a systematic review of the last five years.

机构信息

Evangelista Torquato Human Reproduction Clinic, Fortaleza-CE, Brazil.

Oswaldo Cruz Foundation (FIOCRUZ), Eusébio-CE, Brazil.

出版信息

JBRA Assist Reprod. 2023 Jun 22;27(2):282-291. doi: 10.5935/1518-0557.20220057.

Abstract

OBJECTIVE

To elucidate through a systematic literature review the impact sperm DNA fragmentation has on embryos from assisted reproduction techniques.

DATA SOURCE

Studies from the "PubMed", "Embase", and "BVS" databases were analyzed.

STUDIES SELECTION

The articles selected in the review included: cohort and case-control studies that addressed the proposed theme, published between January 1, 2017, and January 31, 2022, in English, Portuguese, and Spanish. As inclusion criteria: cohort and case-control articles. As exclusion criteria: articles outside the scope of the research, review articles, case reports, articles using animal models, abstracts, letters to the editor, and articles found duplicates in the databases.

DATA COLLECTION

Number of couples or cycles; age (men/women); collection type; DNA damage (%); assisted reproduction activity and techniques.

DATA SYNTHESIS

In in vitro fertilization, a reduction in fertilization rate, blastocyst rate, and embryo quality was observed. In addition to implantation and increased abortion rates in patients with high sperm DNA fragmentation. High rates of sperm DNA fragmentation in intracytoplasmic sperm injection led to reduced blastocyst production rate, embryo quality, implantation, and live birth rate, and in intrauterine insemination, a reduction in pregnancy rate.

CONCLUSION

Sperm DNA fragmentation was a potential limiting factor for assisted reproduction techniques.

摘要

目的

通过系统文献回顾,阐明辅助生殖技术中精子 DNA 碎片化对胚胎的影响。

资料来源

对“PubMed”、“Embase”和“BVS”数据库中的研究进行了分析。

研究选择

综述中选择的文章包括:2017 年 1 月 1 日至 2022 年 1 月 31 日期间以英文、葡萄牙文和西班牙文发表的,涉及提出的主题的队列和病例对照研究。纳入标准:队列和病例对照文章。排除标准:研究范围以外的文章、综述文章、病例报告、使用动物模型的文章、摘要、社论、在数据库中发现重复的文章。

资料收集

夫妇或周期数量;年龄(男性/女性);采集类型;DNA 损伤(%);辅助生殖活动和技术。

资料综合

体外受精中,受精率、囊胚率和胚胎质量下降。此外,高精子 DNA 碎片化的患者着床率和流产率增加。胞浆内精子注射中精子 DNA 碎片化率高导致囊胚生成率、胚胎质量、着床和活产率降低,而在宫腔内人工授精中,妊娠率降低。

结论

精子 DNA 碎片化是辅助生殖技术的一个潜在限制因素。

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