Kruger T F, Franken D R, Stander E, Swart Y, Van der Merwe J P
Department of Obstetrics & Gynaecology, Tygerberg Hospital, South Africa.
Arch Androl. 1993 Sep-Oct;31(2):127-31. doi: 10.3109/01485019308988390.
The aim of this study was to evaluate the influence of sperm morphology, swim-up concentration, and insemination volume on pregnancy outcome in patients undergoing gamete intrafallopian transfer (GIFT) treatment in whom the male partner had a morphology of less than 14%. Only patients who received four oocytes were entered into this study (n = 103). In all cases the swim-up procedure time was standardized to 1 h and the insemination concentration was standardized to 500,000 per oviduct. There was no significant difference in pregnancy rate when normal morphology, swim-up concentration, or insemination volume were used as predictors. In the P pattern group (< 4% normal forms) only four of the 28 (14%) patients had ongoing pregnancies, whereas in the G pattern group (5% to 14% normal forms) 16 out of 75 (21%) had ongoing pregnancies (P vs G, p > 0.05; not significant). The fertilization rate among excess oocytes in the P pattern group was 18% but was 39% (p < .0001) in the G pattern group. When an attempt was made to compensate for low morphology by increasing insemination concentration no significant difference in the pregnancy rate between the P and G pattern groups in the GIFT program was recorded. This was not the case when the in vitro fertilization rate was used as an endpoint. Insemination volume and swim-up concentration played no role in pregnancy rate.
本研究的目的是评估精子形态、上游法处理后的浓度以及授精量对接受配子输卵管内移植（GIFT）治疗的患者妊娠结局的影响，这些患者的男性伴侣精子形态低于14%。仅纳入接受了4个卵母细胞的患者（n = 103）。在所有病例中，上游法处理时间标准化为1小时，授精浓度标准化为每条输卵管50万个。将正常形态、上游法处理后的浓度或授精量作为预测指标时，妊娠率无显著差异。在P型组（正常形态<4%）中，28例患者中只有4例（14%）有持续妊娠，而在G型组（正常形态5%至14%）中，75例中有16例（21%）有持续妊娠（P型组与G型组比较，p>0.05；无显著性差异）。P型组多余卵母细胞的受精率为18%，而G型组为39%（p<0.0001）。当试图通过增加授精浓度来弥补形态学不佳时，GIFT方案中P型组和G型组的妊娠率无显著差异。但以体外受精率作为终点时情况并非如此。授精量和上游法处理后的浓度对妊娠率无影响。
