| Objective:To compare the influence of different sperm morphology groups on the outcome of in vitro fertilization-embryo transfer(In vitro fertilization and embryo transfer,IVF-ET)treatment.After the inclusion of sperm DNA fragmentation index(DNA fragmentation index,DFI),the difference in the outcome of IVF treatment between each group was compared again,so as to clarify the application value of sperm morphology combined with sperm nuclear chromatin in the outcome of IVF treatment.To clarify the application value of sperm morphology combined with sperm nuclear chromatin in the outcome of IVF treatment.Methods:A retrospective study was conducted on 242 fresh cycles of IVF-ET treatment in the reproductive center of Maternal and Child Health Hospital of Jiujiang City October 2019 to December 2020,of which 11 cycles were canceled for female clinical reasons,and a total of 231 cases entered the treatment cycle.Diff-qucik staining and sperm chromatin dispersion(Sperm chromatin dispersion,SCD)were used to evaluate the sperm morphology and the deoxyribonucleic acid(Deoxyribo Nucleic Acid,DNA)integrity of sperm on the day of oocyte retrieval.According to the percentage of normal morphology sperm(Normal morphology sperm,MNS),164 cases were divided into normal morphology group(MNS≥4%)and 67 cases were abnormal morphology group(MNS<4%),the fertilization rates,two pronuclei(Two Pronuclei,2PN)fertilization rates,2PN zygote transgene rates,optimal embryo rates,clinical pregnancy rate,early abortion rate were compared between the two groups.After the inclusion of sperm DFI,the patients were divided into group A(MNS≥4% and DFI<30%),group B(MNS≥4% and DFI≥30%),group C(MNS<4% and DFI<30%)and group D(MNS<4% and DFI≥30%),compare the data difference in each group of IVF-ET treatment.To study the correlation of DFI with male age,semen volume,sperm concentration,forward motility sperm rate,and sperm morphology.Results:1.In general data,there is no statistical significance in the distribution of semen volume,sperm concentration,forward motility sperm rate,male and female age,follicle stimulating hormone(Follicle stimulating hormone,FSH),number of retrieved oocytes,days of gonadotropins(Gonadotropins,Gn),endometrial thickness,and number of transplanted embryos in different sperm morphology groups(P >0.05).After the inclusion of sperm DFI,the average forward motility sperm percentage in group D(32.71±14.80%)was significantly lower than that in group A(40.76±15.58%)(P=0.045),and there was no statistically significant difference in the other cases(P>0.05).2.In terms of fertilization,the fertilization rates and 2PN fertilization rates in normal morphology group(81.67,77.9%)were significantly higher than those in abnormal morphology group(81.67,77.9%)(P<0.05).After the inclusion of sperm DFI,pair comparison between groups showed that the fertilization rates and 2PN fertilization rates of groups C and D were significantly lower than those of groups A and B(P < 0.0083),while there was no statistical difference between the other groups(P>0.0083).3.In terms of embryos,zygote transgene rates and optimal embryo rates of the normal morphology group were 98.17% and 44.73%,while those in the abnormal morphology group were 97.5% and 41.39%,there was no statistical difference between the two groups(P>0.05).After DFI was included,pair comparison showed that zygote transgene rates of group D(94.58%)was significantly lower than that of group A(98.43%)and group C(98.87%),and optimal embryo rates of group B and D(32.57,28.66%)was significantly lower than that of group A and group C(47.86,47.01%)(P<0.0083).4.In terms of pregnancy outcome,there was no significant difference in clinical pregnancy rate(50.61,44.78%)and early abortion rate(10.84,16.67%)between normal morphology group and abnormal morphology group(P > 0.05).After the inclusion of sperm DFI,the clinical pregnancy rate of group B(32.57%)was significantly lower than that of group A(56.25%)(P < 0.0083).In terms of early abortion rate,although D group had the highest abortion rate,due to the small sample size,no difference was shown between groups(P>0.05).5.Among the correlations of DFI with male age and other semen parameters,there was a significant postive correlation between DFI and male age(t=3.087,P<0.05),and a significant negative correlation between DFI and forward motility sperm(t=-5.319,P<0.05).Semen volume,sperm concentration and sperm morphology had no correlation with DFI(P>0.05).Conclusion:Sperm DFI plays a good role in predicting embryonic development,excellent embryo formation and pregnancy outcome,while sperm morphology has a significant impact on fertilization.High fertilization rates will bring more embryos,which has a certain impact on cumulative pregnancy rate.The combined evaluation of the two can bring more efficient and accurate predictive value for the outcome of IVF-ET treatment,so as to improve the success rate of IVF treatment,which is worthy of clinical promotion and application.At the same time,in the treatment of IVF,we should also be concerned about the age of the man,to avoid the many adverse effects of advanced age. |
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