国际妇产科学杂志

国际妇产科学杂志 ›› 2011, Vol. 38 ›› Issue (1): 72-75.

• 论著 • 上一篇    下一篇

精子形态对体外受精 胚胎移植妊娠结局的影响

李晓晔 白晓红 宋学茹 吕 睿 王艳霞   

  1. 300052 天津医科大学总医院生殖医学中心
  • 收稿日期:1900-01-01 修回日期:1900-01-01 出版日期:2011-02-15 发布日期:2011-02-15
  • 通讯作者: 白晓红

Influence of Sperm Morphology on Pregnancy Result in in-Vitro-Fertilization and Embryo Transfer

LI Xiao-ye, BAI Xiao-hong, SONG Xue-ru, LU Rui, WANG Yan-xia   

  1. Reproductive Medical Centre, Tianjin Medical University General Hospital, Tianjin 300052, China
  • Received:1900-01-01 Revised:1900-01-01 Published:2011-02-15 Online:2011-02-15
  • Contact: BAI Xiao-hong

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摘要： 目的：分析男性精液参数与卵裂率、优质胚胎率及妊娠率的相关性，探讨体外受精-胚胎移植（IVF-ET）周期中精子形态对精子功能的影响。方法：分析82个受精率100%的IVF-ET周期。以Diff-Quick stain方法染色，密度梯度离心法处理精液，WHO精子形态学标准评估精子形态，精子正常形态率≥14%为正常组，＜14%者为异常组。观察精液处理前后精子参数变化，比较妊娠组与未妊娠组的年龄、移植日子宫内膜厚度和精液各参数的情况。比较精液处理前后精子正常形态率与两组的正常受精率、卵裂率、优质胚胎率和妊娠率。结果：①密度梯度离心法处理后82例精液密度明显降低，活动力明显提高，差别有统计学意义。②精液处理前精子正常形态率：正常组11例（13.41%），异常组71例（86.59%）；处理后正常组34例（41.46%），异常组48例（58.53%）。异常组精液处理后正常精子形态的比例提高，中位数（P25，P75）分别为8.15%（6.38%，10.50%） vs. 12.41%（9.98%，18.58%），差别有统计学意义（P ＜0.01）。③精液处理前精子正常形态率正常组和异常组的密度和活动力差别无统计学意义（P ＞0.05）。④精液处理前后精子正常形态率正常组和异常组的妊娠率和优质胚胎率差异均无统计学意义（P ＞0.05）；精子正常形态率正常组的卵裂率高于异常组（P ＜0.05）。⑤妊娠组和未妊娠组除男女双方年龄差异有统计学意义外，移植日子宫内膜厚度和各精液参数差异均无统计学意义。结论：精子形态对妊娠结局无预测，密度梯度离心法能提高正常精子形态百分数，需根据精液处理后的结果选择受精方式。

关键词: 不育, 精子, 精液, 生殖技术, 辅助, 离心法, 密度梯度, 妊娠结局

Abstract: Objective: To Analyze the relation between the sperm parameters and cleavage rate, the quality of embryos and the pregnancy rate, investigate the impact of sperm morphology on spermatozoal functions in in-vitro-fertilization. Methods: We only included couples whose fertilization rate was 100%. A total of 82 cycles were included in our study. Before and after density gradient centrifugation, sperm morphology was evaluated by Diff-Quik stain according to the WHO criterion. The normal proportion of normal morphology sperm is ≥14%, and ＜14% is abnormal. Investigate and analyze the change of sperm parameters before and after density gradient centrifugation, female patient’s age, endometrium thickness, and sperm parameters. Compare morphology, normal fertilization rate, cleavage rate, the quality of embryos and the pregnancy rate between two groups before and after sperm preparation. Results: ①After density gradient centrifugation, all of 82 samples semen density reduced and sperm motility improved significantly. ②Before sperm preparation, 11 samples（13.41%）were normal and 71 (86.59%) were abnormal; after preparation, 34（41.46%）samples were normal and 48（58.53%）were abnormal. The normal proportion of normal morphology sperm of abnormal samples improved obviously（P ＜0.01）, median（P25, P75） are 8.15%（6.38%, 10.50%）vs. 12.41% （9.98%, 18.58%）. ③There are no significant difference in density and motility between normal and abnormal groups before spem preparation（P ＞0.05）. ④Follow up analysis showed that the normal group had no higher clinical pregnancy rate and higher quality embryos rate （P ＞0.05） but higher cleavage rate（P ＜0.05）than the abnormal one. ⑤There were no significant differences for endometrium thickness and sperm parameters except the couples age between two groups of pregnancy or not. Conclusion: There is no significant prognosis of human normal morphology sperm rate on pregnancy outcomes of IVF-ET. Density gradient centrifugation can increase the normal morphology sperm percentage. The selection of the insemination methods should be made according to the results after density gradient centrifugation.

Key words: nfertility, Spermatozoa, Semen, Reproductive techniques, assisted, Centrifugation, Pregnancy outcome