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目的:通过分析精子染色质完整性与体外受精胚胎移植(IVF-ET)、卵细胞胞质内单精子注射(ICSI)结局之间的关系,探讨精子染色质完整性检测在辅助生殖技术(ART)中的预测价值。方法:采用精子染色质结构分析试验(SCSA)方法检测187个ART周期中精子的染色质完整性,以精子DNA损伤指数(DFI)为参数,分为高DFI组(DFI≥30%)和低DFI组(DFI<30%),两组中根据采用不同的体外受精方式分为IVF亚组和ICSI亚组。分别比较高DFI组、低DFI组中IVF亚组和ICSI亚组间受精率、卵裂率、D2天胚胎质量、D3天胚胎质量、临床妊娠率差异性。结果:在高DFI组中,行ICSI治疗的夫妇临床妊娠率显著高于行IVF治疗的夫妇,具有统计学意义;在行IVF治疗的夫妇中,比较高DFI组与低DFI组的各临床结局,未见统计学差异;在行ICSI夫妇中,比较高DFI组与低DFI组的各临床结局,未见统计学差异。结论:精子染色质完整性影响辅助生育技术的结局,在选择辅助生殖技术方案时,可作为常规精液检查的一个补充。
OBJECTIVE: To investigate the relationship between chromatin integrity of sperm and in vitro fertilization embryo transfer (IVF-ET) and intracytoplasmic sperm injection (ICSI) In the forecast value. Methods: The chromatin integrity of sperm in 187 ART cycles was detected by the method of sperm chromatin structure analysis (SCSA). The parameters of sperm DNA damage index (DFI) were divided into high DFI group (DFI≥30%) and low DFI group (DFI <30%). The two groups were divided into IVF subgroup and ICSI subgroup according to different in vitro fertilization methods. The differences of fertilization rate, cleavage rate, D2 embryo quality, D3 embryo quality and clinical pregnancy rate between IVF subgroup and ICSI subgroup were higher in DFI group and DFI group respectively. Results: In the high DFI group, the clinical pregnancy rates of couples undergoing ICSI were significantly higher than those of couples undergoing IVF, and were statistically significant among the couples who underwent IVF and those between the DFI group and the low DFI group , No statistical difference; ICSI couples in the line, the higher the DFI group and low DFI group of clinical outcomes, no statistical difference. CONCLUSIONS: The integrity of sperm chromatin affects the outcome of assisted reproductive technology and may be used as a supplement to routine semen testing when selecting an assisted reproductive protocol.