| Objective: To systematically detect and analyze the related parameters of routine semen,sperm acrosome function and sperm DNA fragment rate in infertile men who need IVF-ET(in vitro fertilization and embryo transfer).The purpose of this study was to explore the relationship between sperm DFI and routine semen parameters and sperm acrosome function parameters.2.The relationship between sperm DFI and IVF-ET fertilization,embryonic development and pregnancy outcome.Methods: the subjects of this study were couples who needed IVF-ET assisted pregnancy from the Reproductive Center of Guangxi Zhuang Autonomous region people’s Hospital from January 201 7 to December 2019.According to the inclusion criteria and exclusion criteria in this study,sperm acrosome function parameters and routine semen tests were performed on infertile men in 1413 fresh embryo transfer cycles.The DNA fragment rate of spermato zoa was detected by SCD method(Sperm Chromatin Dispersion method).According to the DNA fragmentation rate of sperm,they were divided into three groups: group A,group B and group C.the DFI of group A was more than 30%,and that of group B was 15 ≤ DFI < 30%.The DFI of group C was less than 15%.The structural integrity of sperm DNA in group A,group B and group C were described by three evaluation indexes: poor,general and good.There are 76 cycles in group A,278 cycles in group B and 1059 cycles in g roup C.Finally,the semen routine parameters,sperm acrosome function parameters,fertilization after IVF-ET assisted pregnancy,embryonic development and pregnancy outcome of the three groups were compared and analyzed,and relevant conclusions were drawn.Results:(1)the basic conditions of patients in each sperm DFI group were compared between groups.There was no significant difference in age,type of infertility,years of infertility,body mass index,FSH(Follicle Stimulating Hormone),AMH(Anti Mul lerian Hormone)and the number of follicles in female antrum between male and female(P > 0.05).(2)the routine semen parameters and sperm acrosome function parameters of patients in each sperm DFI group were compared.In different DFI level groups,there were significant differences in sperm motility,semen volume,sperm density,sperm acrosome integrity rate,normal sperm morphology percentage and sperm acrosome spontaneous reaction rate among the three groups(P<0.05).At the same time,there were signi ficant differences between the two groups(P<0.05).Among them,the sperm concentration,semen volume,sperm motility,sperm acrosome integrity rate and the percentage of normal sperm morphology were the highest in group C,the second in group B and the lowest in group A.The rate of sperm acrosome reaction was the highest in group A,the second in group B and the lowest in group C.There was no significant difference in the age of the man in each group(P>0.05).(3)the related observation indexes of ferti lization and embryonic development of patients in each sperm DFI group were compared between groups.In different DFI level groups,there were significant differences in cleavage number,cleavage rate,high quality embryo rate,high quality blastocyst numb er and high quality blastocyst formation rate among the three groups.There was no significant difference in the number of oocytes obtained,MII oocytes,2PN fertilized eggs,2PN fertilization rate,high quality embryos and blastocyst formation among diffe rent DFI level groups.However,from group A to group C,the number of high quality embryos and blastocyst formation increased with the decrease of sperm DNA fragmentation rate.(4)the parameters related to pregnancy outcome after IVF-ET assisted pregnancy in each sperm DFI group were compared between groups.There was no significant difference in biochemical pregnancy rate,clinical pregnancy rate,embryo implantation rate,abortion rate and live birth rate among different sperm DFI levels.(5)the results of multivariate binary Logistic regression analysis showed that the age of the woman and sperm motility had a significant effect on the live birth.The effect of sperm DFI grouping on live birth was not significant.(6)the results of ROC curve analysis of sperm DFI and sperm motility to predict the main pregnancy outcome(live birth)showed that sperm DFI and sperm motility had no clinical significance in predicting live birth.Conclusions: 1.Sperm DNA fragmentation rate(DFI)was ne g-atively correlated with sperm concentration,sperm motility,per centage of normal sperm morpholo gy and sperm acrosome functi o-n.Sperm DFI can be used to eval uate the fertility potential o fmen more comprehensively.It is suggested that sperm DFI sho u-ld be used as a supplementary method to evaluate the semen q-uality of infertile men.2.Based on the strict control of non-spe rm factors,the sperm DNA fragment rate(DFI)has no significa-nt correlation with in vitro fertilization rate and pregnancy-relat ed outcome,but it has a significant negative correlation with e m-bryonic development.Sperm DNA fr agment rate(DFI)can be u-sed as an independent index for predicting the ou tcome of em bryonic development.3.The age of the woman has a significant e-ffect on the main outcome of preg nancy(live birth).It is sugg-ested that if there are infertility factors in elderly women,artif ic-ial assisted reproduction should be performed as soon as poss ib-le to ensure a satisfactory pregnancy outcome. |
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