| Background::In recent years,the incidence of infertility in the world has increased significantly.At present,the prevalence rate of infertility in China is about 15%,of which the male factor accounts for about 40%-50%,infertility.Infertility involves multiple possible pathogenic factors throughout the diagnosis and treatment process.In addition to the factors that may influence the pregnancy process and pregnancy outcomes,the male factors,such as semen concentration,sperm motility,and percentage of normal sperm morphology,are evaluated.Male infertility factors play an important role and will also have an impact on pregnancy outcomes.research shows that the predictive value of this important index of predictive value of ART,semen,is very limited.Among the classic semen routine examination,sperm concentration,sperm motility,and normal sperm morphology,etc.Changes in time will produce large fluctuations.Therefore,routine semen testing has limited predictive value for sperm fertility and has limited predictive value for successful pregnancy and normal development.Moreover,studies have shown that about 15%of infertility patients do not have obvious abnormalities in the routine detection of semen.[1]In addition,studies have confirmed that there is a high level of sperm DFI in approximately 8%of patients even if there is no significant abnormality in semen routine testing.[2]There is now a need for a new evaluation indicator tore-evaluate male fertility,or to supplement semen routine analysis.[3]Some scholars have suggested that highly intact sperm DNA is necessary for successful fertilization and maintenance of normal embryonic development.[4]However,there is controversy in the academic community as to whether the level of sperm DFI has a negative impact on pregnancy-related outcomes.[5]With the further development of ART research,the research on sperm DNA fragmentation rate has gradually increased,becoming a more convincing indicator of male fertility assessment after routine analysis of semen.Compared with conventional semen routine parameters,sperm DFI Has good stability and specificity,can make up for the lack of routine analysis of semen,and has better guiding significance for the choice of treatment program and the judgment of treatment effect.Objective:To investigate the effect of the rate of sperm DNA fragmentation on the IVF/ICSI pregnancy outcome.Methods:The experimental method for this study was the sperm chromatin structure assay(SCSA),which screened the couple who received IVF/ICSI assisted pregnancy from 2015 to 2016 and whose men performed DFI examination,and grouped according to DFI.With DFI ≥ 15%as the abnormal cut-off value,the infertile patients were divided into group A(DFI<15%)and group B(DFI ≥ 15%).SPSS 19.0 statistical software was used for data analysis.Samples were found to correspond to approximately normal distributions as mean ± standard deviation.Independent-sample t test was used for comparisons between multiple groups;biochemical pregnancy rate,clinical pregnancy rate,miscarriage rate,and live birth.The rate was compared using a four-squared chi-square test.P<0.05 was considered statistically significant.Results:A total of 211 samples were included in the study and met the criteria.DFI≥ 15%was defined as the abnormal cutoff and divided into A and B groups.DFI was less than 15%in group A,and DFI ≥ 15%in group B.Sample A was included.The number was 184 cases,and group B was 27 cases.The fertilization rate in group A compared with group B(63±21.5)vs(68±19.1),the rate of good embryos(55±28.2)vs(59±27.9),and the biochemical pregnancy rate 16.3%(30/184)vs 18.5%(5/27),clinical pregnancy rate was 41.3%(76/184)vs 48.1%(13/27)compared with no statistical significance(P values were greater than 0.05);group A had a miscarriage rate of 10.8%(20/184))Compared with group B,the abortion rate was 37.0%(10/27),the live birth rate of group A was statistically significant when compared with the live birth rate of 30.4%(56/184)vs group B,11.1%(3/27).(P values are less than 0.05).Conclusion:With DFI ≥ 15%as the abnormal cut-off value,high DFI has no effect on the fertilization rate,high-quality embryo rate,biochemical pregnancy rate,clinical pregnancy rate outcome in the subsequent IVF/ICSI,but has a correlation with abortion rate and live birth rate.Impact,high DFI will increase the miscarriage rate and reduce the live birth rate. |
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