摘要： 目的 探讨男性精子DNA碎片指数（DFI）对体外受精不同助孕方式妊娠结局的影响。方法 回顾性分析683对不孕夫妇新鲜移植周期的临床资料，其中体外受精（IVF） 367个周期、卵胞质内单精子注射（ICSI） 316个周期。将全部研究对象、IVF周期和ICSI周期分别根据DFI值分为DFI≤15%组、DFI>15%~30%组、DFI>30%组。分析DFI与精液常规、精子形态学的相关性，DFI对IVF/ICSI新鲜移植周期妊娠结局的影响。结果 随着禁欲天数增加，DFI升高，但精子浓度和前向运动精子百分率均显著下降（P < 0.001）。IVF周期中，DFI≤15%组、DFI>15%~30%组、DFI>30%组比较，临床妊娠率（55.5%、57.6%、71.4%）和活产率（43.5%、45.8%、42.9%）的差异无统计学意义（P > 0.05）。ICSI周期中，DFI>30%组的临床妊娠率和活产率（25.0%和16.7%）均显著低于DFI≤15%组（48.5%和36.9%）、DFI>15%~30%组（51.1%和39.4%）（P < 0.05）。结论 精子DFI与精子浓度、前向运动精子百分率呈负相关，与禁欲天数呈正相关。DFI对不同助孕方式新鲜移植周期的妊娠结局有一定影响。

精子DNA碎片指数对体外受精不同助孕方式妊娠结局的影响

檀畅, 王喜良, 张金艳, 魏威, 邹朋书, 罗丽双, 于月新

北部战区总医院生殖医学科, 沈阳 110003

收稿日期:2021-11-16出版日期:2022-09-30发布日期:2022-09-03
通讯作者:于月新E-mail:yuyuexinpingan@163.com
作者简介:檀畅（1990-），女，主管技师，硕士.
基金资助:辽宁省科学技术计划（2020JH2/10300118）


关键词: 精子DNA碎片指数, 体外受精, 卵胞质内单精子注射, 临床妊娠率
Abstract: Objective To explore the effect of male sperm DNA fragmentation index(DFI) on the pregnancy outcomes of different methods of in vitro fertilization(IVF). Methods The clinical data of 683 infertile couples who had undergone fresh embryo transplantation were retrospectively analyzed. There were 367 cycles of IVF and 316 cycles of intracytoplasmic sperm injection(ICSI). All the subjects, IVF cycles, and ICSI cycles were divided into DFI ≤ 15%, DFI>15%-30%, and DFI>30% groups, respectively. The correlation of DFI with semen routine and sperm morphology and the influence of DFI on the pregnancy outcomes of IVF/ICSI fresh transplantation cycles were analyzed. Results With an increase in abstinence duration, DFI increased, but sperm concentration and progressive motility significantly decreased(P < 0.001). There were no significant differences in the clinical pregnancy rate(55.5%, 57.6%, and 71.4%) and live birth rate(43.5%, 45.8%, and 42.9%) among the DFI ≤ 15%, DFI>15%-30%, and DFI>30% groups, respectively, for IVF cycles(P > 0.05). During ICSI cycles, the clinical pregnancy rate and live birth rate in the DFI>30% group(25.0% and 16.7%, respectively) were significantly lower than those in the DFI ≤ 15%(48.5% and 36.9%, respectively) and DFI>15%-30% groups(51.1% and 39.4%, respectively; P < 0.05). Conclusion Sperm DFI was negatively correlated with sperm concentration and the percentage of sperm progressive motility, and was positively correlated with abstinence duration. DFI may have a relatively limited effect on the pregnancy outcomes of fresh transplant cycles with different methods of IVF.
Key words: sperm DNA fragmentation index, in vitro fertilization, intracytoplasmic sperm injection, clinical pregnancy rate
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