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目的:探讨精液处理前后精子形态学变化及其对人工授精结局的影响。方法:回顾性分析185对共228个人工授精周期,精液经密度梯度离心法处理,形态学分析严格按照WHO《人类精液检查与处理实验室手册》第5版标准,比较处理前后精子形态<4%和≥4%两组对妊娠结局的影响以及其对女性年龄和不孕年限各组的影响。结果:处理前精子形态<4%组,周期妊娠率为14.6%(14/96),处理前精子形态≥4%组,周期妊娠率为12.8%(17/132),无统计学差异(P>0.05);处理后精子形态<4%组,周期妊娠率为8.7%(6/69),处理后精子形态≥4%组,周期妊娠率为15.7%(25/159),无统计学差异(P>0.05)。处理前精子形态<4%和≥4%两组在不同女性年龄和不孕年限各组间无差异(P>0.05);处理后精子形态<4%和≥4%两组,当女性年龄>35岁时,妊娠率分别为0(0/39)、14.3%(6/42),差异显著(P<0.05);当女性不孕年限>5年时,妊娠率分别为0(0/38)、14.0%(6/43),差异有显著性(P<0.05)。结论:当处理后精子形态<4%,女性年龄>35岁或女性不孕年限>5年时妊娠率明显降低,应及时行IVF或ICSI治疗。
Objective: To investigate the morphological changes of sperm before and after semen treatment and its effect on the outcome of artificial insemination. METHODS: A total of 228 pairs of 228 artificial insemination cycles were retrospectively analyzed. Semen was processed by density gradient centrifugation. Morphological analysis was performed in strict accordance with the 5th edition of the WHO Manual of Human Semen Inspection and Processing Laboratory The effects of% and ≥4% on pregnancy outcomes and their effect on females’ age and duration of infertility in each group. Results: The pre-treatment sperm morphology was less than 4%, the pregnancy rate was 14.6% (14/96), pre-treatment sperm morphology was 4%, and the cycle pregnancy rate was 12.8% (17/132), with no significant difference (P > 0.05). After treatment, sperm morphology was less than 4%, the rate of pregnancy was 8.7% (6/69), sperm morphology was more than 4%, and the rate of pregnancy was 15.7% (25/159) (P> 0.05). There was no significant difference between groups (P> 0.05) in sperm morphology <4% and ≥4% before and after treatment. The sperm morphology of <4% and ≥4% At 35 years of age, the pregnancy rates were 0 (0/39) and 14.3% (6/42) respectively, with significant differences (P <0.05). The pregnancy rates were 0 (0/38 ), 14.0% (6/43), the difference was significant (P <0.05). Conclusion: The pregnancy rate of sperm morphology <4%, female age> 35 years or female infertility> 5 years is obviously reduced after treatment. IVF or ICSI should be performed in time.