Ye Danna, Ye Zhujun, Zhang Huan
Reproductive Medicine Center, The First Affiliated Hospital of Wenzhou Medical University, Fuxuexiang 96#, Lucheng District, Wenzhou, 325000, Zhejiang, China.
Arch Gynecol Obstet. 2025 Feb 16. doi: 10.1007/s00404-025-07949-0.
Whether SDF (sperm DNA fragmentation) influences embryo development and the clinical outcomes of assisted reproductive technology (ART) cycles remains controversial. Oocytes derived from women of different ages have varying abilities to repair SDF.
This study aimed to explore the correlation between SDF and the morphokinetic parameters of embryos during intracytoplasmic sperm injection (ICSI) treatment cycles with consideration of the different ages of female patients.
A total of 301 ICSI cycles between April 2022 and December 2023 were analyzed in this retrospective study. Cycles were categorized into two groups according to female age: the older group (females aged ≥ 35 years) and the younger group (females aged < 35 years). Moreover, each age group was further divided into low- and high- sperm DNA fragmentation index (DFI) subgroups. The morphokinetic parameters of embryo development and the laboratory outcomes were compared between the two DFI subgroups within each age category.
In the younger group, there were no differences between the two DFI groups in terms of the rate of usable blastocyst formation on Day 5; time to 2, 3, 4, 5, 6, 7, and 8 cells; or timing of blastulation. However, in the older group, the rate of usable blastocyst formation on Day 5 was significantly greater in the low DFI group than in the high DFI group (35.6% vs. 23.4%, p = 0.030). Although the times to reach 2, 3, 4, 5, 6, 7, and 8 cells were similar across the two DFI groups, the time to blastulation (tB) was significantly shorter in the low DFI group than in the high DFI group (106.5 ± 9.0 h vs. 111.1 ± 10.3 h, p = 0.013).
SDF could adversely affect the rate of usable blastocyst formation on Day 5 and delay the formation of usable blastocysts only when oocytes were derived from women of advanced maternal age. These results may indicate that oocytes derived from younger females have a greater capacity to repair SDF than those from women of advanced maternal age.
精子DNA碎片（SDF）是否会影响胚胎发育以及辅助生殖技术（ART）周期的临床结局仍存在争议。不同年龄女性来源的卵母细胞修复SDF的能力各不相同。
本研究旨在探讨卵胞浆内单精子注射（ICSI）治疗周期中SDF与胚胎形态动力学参数之间的相关性，并考虑女性患者的不同年龄。
本回顾性研究分析了2022年4月至2023年12月期间的301个ICSI周期。根据女性年龄将周期分为两组：年龄较大组（年龄≥35岁的女性）和年龄较小组（年龄<35岁的女性）。此外，每个年龄组进一步分为低精子DNA碎片指数（DFI）亚组和高DFI亚组。比较每个年龄类别中两个DFI亚组之间胚胎发育的形态动力学参数和实验室结局。
在年龄较小组中，两个DFI组在第5天可用囊胚形成率、达到2、3、4、5、6、7和8细胞的时间或囊胚形成时间方面没有差异。然而，在年龄较大组中，低DFI组第5天可用囊胚形成率显著高于高DFI组（35.6%对23.4%，p = 0.030）。尽管两个DFI组达到2、3、4、5、6、7和8细胞的时间相似，但低DFI组的囊胚形成时间（tB）显著短于高DFI组（106.5±9.0小时对111.1±10.3小时，p = 0.013）。
只有当卵母细胞来自高龄产妇时，SDF才会对第5天可用囊胚形成率产生不利影响并延迟可用囊胚的形成。这些结果可能表明，年轻女性来源的卵母细胞比高龄产妇来源的卵母细胞具有更强的修复SDF的能力。
