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精子 DNA 碎片化对不明原因不孕的体外受精结局的影响。

The effect of sperm DNA fragmentation on in vitro fertilization outcomes of unexplained infertility.

机构信息

Dushu Lake Hospital Affiliated to Soochow University, Jiangsu, China; Affiliated Hospital of Nantong University, Jiangsu, China.

Affiliated Hospital of Nantong University, Jiangsu, China.

出版信息

Clinics (Sao Paulo). 2023 Jul 27;78:100261. doi: 10.1016/j.clinsp.2023.100261. eCollection 2023.

Abstract

BACKGROUND

Infertility is caused by heterogeneous risks, but most of them are unexplained. The sperm DNA Fragmentation Index (DFI) was increasingly acknowledged as a parameter for the evaluation of male infertility. This study aimed to investigate the association between sperm DFI and laboratory and clinical outcomes in a population with unexplained infertility.

METHODS

The clinical data of an infertile population was collected for the selection of reproductive patients with unexplained infertility. The authors classified the patients with normal sperm parameters in a control group (DFI < 25%) and an observation group (DFI ≥ 25%) and compared the difference in basal characteristics, laboratory, and clinical outcomes between the two groups. The authors conducted a correlation analysis to examine the relationship between DFI and the number of D3 good-quality embryos, as well as the clinical pregnancy rate and live birth rate. A total of 176 cases were enrolled in the retrospective study.

RESULTS

The observation group (n = 88) showed advanced male age, lower sperm concentration, progressive motility, and morphology assessment than the control group. In addition, lower No. of D3 good-quality embryos, clinical pregnancy rate, and the live birth rate were shown in the observation group. A negative correlation between the DFI and No. of D3 good-quality embryos (rs = -0.347, p < 0.001) or live birth rate (rs = -0.185, p = 0.028) was shown.

CONCLUSIONS

Sperm DFI was a good indicator for the prediction of D3 good-quality embryos in unexplained infertility couples, but it did not provide sufficient information regarding clinical pregnancy outcome but live pregnancy outcome.

摘要

背景

不孕的原因具有异质性,但大多数原因尚未阐明。精子 DNA 碎片指数(DFI)越来越被认为是评估男性不育的一个参数。本研究旨在探讨精子 DFI 与不明原因不孕人群中实验室和临床结局的关系。

方法

收集不孕人群的临床数据,选择不明原因不孕的生殖患者。作者将精子参数正常的患者分为对照组(DFI<25%)和观察组(DFI≥25%),比较两组患者的基础特征、实验室和临床结局的差异。作者进行了相关性分析,以检验 DFI 与 D3 优质胚胎数量、临床妊娠率和活产率之间的关系。共纳入 176 例回顾性研究病例。

结果

观察组(n=88)的男性年龄较大,精子浓度、前向运动精子百分率和形态评估均低于对照组。此外,观察组的 D3 优质胚胎数量、临床妊娠率和活产率较低。DFI 与 D3 优质胚胎数量(rs=-0.347,p<0.001)或活产率(rs=-0.185,p=0.028)呈负相关。

结论

精子 DFI 是预测不明原因不孕夫妇 D3 优质胚胎的良好指标,但对临床妊娠结局没有提供足够的信息,而对活产妊娠结局有一定的预测价值。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/88fd/10407277/b200a4013f06/gr1.jpg

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