Huang Xuan, Wang Cen-Cen, Wang Hui, Yao Bing, Chen Li
Department of Reproductive Medicine, Jinling Hospital Affiliated to Nanjing University / General Hospital of Eastern Theater Command, Nanjing, Jiangsu 210002, China.
Zhonghua Nan Ke Xue. 2024 Aug;30(8):722-729.
To investigate the effects of sperm DNA fragmentation index (DFI) on embryonic development and live birth outcomes of in vitro fertilization-fresh embryo transfer (IVF-ET).
We selected 947 cases of IVF-ET due to female factors from June 2015 to December 2020 and, according to the DFI, divided them into a low- (DFI < 15%), a medium- (15 ≤ DFI ≤ 30%) and a high-DFI (30%<DFI) group. We obtained the female factors (including age, body mass index ［BMI］, and baseline levels of sexual hormones and anti-Müllerian hormone ［AMH］), male factors (including age, BMI, and semen parameters), parameters of superovulation induction, semen parameters before and after IVF treatment, outcome of ovulation induction, embryo quality and pregnancy outcome, and compared them among the three groups.
The patients in the medium- and high-DFI groups had a significantly older age than those in the low-DFI group. There were statistically significant differences among the three groups in the baseline percentages of progressively motile sperm, non-progressively motile sperm and immotile sperm, and total sperm motility and progressive sperm motility before IVF (P<0.01). The baseline percentage of morphologically normal sperm, sperm concentration and total sperm count before IVF treatment, and sperm concentration after IVF treatment were significantly lower in the medium- and high-DFI groups than in the low-DFI group, and so was the total sperm count in the high-DFI than in the low- and medium-DFI groups either before or after semen treatment (P<0.01). The fertilization rate was also markedly lower in the medium- and high-DFI than in the low-DFI group, but no statistically significant differences were observed in ovulation induction parameters, embryo quality and pregnancy outcome among the three groups.
High DFI significantly affects sperm motility. The DFI level after semen treatment is negatively correlated with sperm concentration, total sperm count and fertilization rate, but does not affect embryo quality and pregnancy outcome.
探讨精子DNA碎片化指数（DFI）对体外受精-新鲜胚胎移植（IVF-ET）胚胎发育及活产结局的影响。
选取2015年6月至2020年12月因女性因素行IVF-ET的947例患者，根据DFI将其分为低DFI组（DFI<15%）、中DFI组（15≤DFI≤30%）和高DFI组（30%<DFI）。获取女性因素（包括年龄、体重指数［BMI］、性激素及抗苗勒管激素［AMH］基线水平）、男性因素（包括年龄、BMI及精液参数）、超促排卵参数、IVF治疗前后精液参数、促排卵结局、胚胎质量及妊娠结局，并在三组间进行比较。
中DFI组和高DFI组患者年龄显著大于低DFI组。三组间IVF前进行性运动精子、非进行性运动精子和不动精子的基线百分比以及总精子活力和进行性精子活力存在统计学差异（P<0.01）。中DFI组和高DFI组IVF治疗前形态正常精子的基线百分比、精子浓度和总精子数以及IVF治疗后的精子浓度均显著低于低DFI组，高DFI组精液处理前后的总精子数也显著低于低DFI组和中DFI组（P<0.01）。中DFI组和高DFI组的受精率也显著低于低DFI组，但三组间促排卵参数、胚胎质量及妊娠结局未观察到统计学差异。
高DFI显著影响精子活力。精液处理后的DFI水平与精子浓度、总精子数和受精率呈负相关，但不影响胚胎质量和妊娠结局。
