Zou Min, Shao Shu-Min, Li Jiao, Zhang Zhong-Yuan, Zhang Ling
Center of Reproductive Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China.
Research Institute of Reproductive Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China.
Zhonghua Nan Ke Xue. 2022 Jan;28(1):20-25.
To analyze sperm function-related risk factors and their value in predicting the fertilization rate (FR) of in vitro fertilization (IVF).
This retrospective study included 668 cases of IVF performed in the Center of Reproductive Medicine, Tongji Medical College, Huazhong University of Science and Technology from July 2018 to April 2021, which were divided into a low-FR group (FR ≤ 65%, n = 107) and a high-FR group (FR > 65%, n = 561). We compared the sperm volume, sperm concentration, percentages of progressively motile sperm (PMS) and morphologically normal sperm (MNS), acrosome reaction rate, acrosin activity and DNA fragmentation index (DFI) between the two groups, analyzed the correlation between sperm parameters and FR by Spearman's correlation analysis, and the value of sperm function-related risk factors in predicting the FR of IVF using binary logistic regression analysis and receiver-operator characteristic (ROC) curve.
There were statistically significant differences in the infertility type of the female patients (P < 0.05) but not in the sperm volume, sperm concentration, PMS, MNS, and acrosome reaction rate (P > 0.05). The DFI was significantly lower in the high-FR than in the low-FR group (［14.31 ± 4.46］% vs ［15.35 ± 5.68］%, P = 0.034) and the acrosin activity remarkably higher in the former than in the latter group (［102.11 ± 47.18］ vs ［91.98 ± 42.61］ μIU/106, P = 0.039). Spearman's correlation analysis showed that the FR was correlated negatively with DFI (r = 0.090, P = 0.020) and positively with acrosin activity (r = 0.079, P = 0.042). Primary infertility and DFI were found to be unfavorable factors while acrosin activity a favorable factor for the FR of IVF. The areas under the ROC curve (AUC) of DFI and acrosin activity were 0.571 and 0.562, respectively.
DFI and acrosin activity are risk factors and have a predictive value for the fertilization rate of IVF.
分析精子功能相关危险因素及其在预测体外受精（IVF）受精率（FR）中的价值。
本回顾性研究纳入了2018年7月至2021年4月在华中科技大学同济医学院生殖医学中心进行的668例IVF病例，分为低受精率组（FR≤65%，n = 107）和高受精率组（FR>65%，n = 561）。比较两组间的精液量、精子浓度、前向运动精子（PMS）百分比、形态正常精子（MNS）百分比、顶体反应率、顶体酶活性和DNA碎片指数（DFI），采用Spearman相关性分析精子参数与FR之间的相关性，并通过二元逻辑回归分析和受试者工作特征（ROC）曲线分析精子功能相关危险因素在预测IVF受精率中的价值。
女性患者的不孕类型存在统计学显著差异（P<0.05），但精液量、精子浓度、PMS、MNS和顶体反应率无显著差异（P>0.05）。高受精率组的DFI显著低于低受精率组（［14.31±4.46］%对［15.35±5.68］%，P = 0.034），且前者的顶体酶活性显著高于后者（［102.11±47.18］对［91.98±42.61］μIU/106，P = 0.039）。Spearman相关性分析显示，FR与DFI呈负相关（r = 0.090，P = 0.020），与顶体酶活性呈正相关（r = 0.079，P = 0.042）。发现原发性不孕和DFI是IVF受精率的不利因素，而顶体酶活性是有利因素。DFI和顶体酶活性的ROC曲线下面积（AUC）分别为0.571和0.562。
DFI和顶体酶活性是IVF受精率的危险因素且具有预测价值。
