| Objective:By analyzing the relationship between sperm routine,sperm morphology and outcomes of in vitro fertilization-embryo transfer(IVF-ET)/intracytoplasmic sperm injection(ICSI)to explore the predictive value of sperm DNA fragment index(DFI)in evaluating male fertility and assisted reproductive technology(ART).Methods:1.The results of 2420 patients who underwent sperm DNA fragment index,semen routine and sperm morphology examination at the reproductive center were retrospectively analyzed.According to DFI values,the patients were divided into group A(DFI?15%),group B(15%<DFI<30%)and group C(DFI?30%).The correlation between semen routine parameters and sperm morphology was analyzed.2.Sperm DFI in 98 ART cycles was detected by sperm chromatin structure analysis test(SCSA).Sperm routine parameters and sperm morphology were detected according to WHO(WHO 5th Edition)standards.Patients were divided into group A(DFI?15%),group B(15%<DFI<30%)and group C(DFI?30%)according to the reference value of sperm DFI.The three groups were divided into IVF subgroup and ICSI subgroup according to different in vitro fertilization methods.The fertilization rate,cleavage rate,excellent embryo rate and clinical pregnancy rate between and within IVF subgroup and ICSI subgroup in groups A,B and C were compared respectively.Results:1.Sperm DFI was negatively correlated with sperm concentration,forward motility sperm(PR)and motility rate,but positively correlated with age,malformation rate and sperm chromatin maturity(HDS)(P<0.01).The difference was statistically significant, but not statistically significant with sperm volume(P>0.05).2.(1)The comparison of clinical outcome between IVF subgroup and ICSI subgroup in group A,B and C: in IVF subgroup,sperm DFI and fertilization rate(c2=7.367,P<0.01)were statistically significant,but there was no significant difference with cleavage rate,excellent embryo rate and clinical pregnancy rate(P>0.05).DFI was correlated with ICSI fertilization rate(c 2=11.202,P<0.01),cleavage rate(c 2=21.847,P<0.01),and excellent embryo rate(c 2=11.887,P<0.01),and there was no significant difference between DFI and clinical pregnancy rate(P>0.05).(2)The results of IVF subgroup and ICSI subgroup in group A,group B and group C were compared: the fertilization rate of ICSI subgroup in group A and group B was higher than that of IVF subgroup,the difference was statistically significant(P<0.01);the excellent embryo rate of ICSI subgroup in group C was higher than that of IVF subgroup,the difference was statistically significant(P<0.05).Conclusion :1.With the increase of DFI,deformity rate and HDS increased,sperm concentration,motility and activity rate all decreased,and the older the sperm was,the higher the DFI was.2.Sperm DFI detection can reflect some sperm quality information independent of routine semen analysis.Therefore,DFI detection can be used as an important sperm quality evaluation index.3.Sperm DFI has certain reference value in predicting ICSI embryo development,but it has limited value in predicting IVF clinical outcome.4.When DFI?30%,ICSI treatment is preferred. |
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