| Objective: To explore the influence of sperm DNA damage on pregnancy outcome of in vitro fertilization embyo transfer/intracytoplasmic sperm injection(IVF-ET/ICSI)patients by detecting sperm DNA fragmentation,semen routine parameters and reactive oxygen species(ROS).Method:1.63 cycles of assisted pregnancy patients who were treated with IVF-ET/ICSI in Reproductive Medicine Center of Loudi Central Hospital from August 2019 to September 2020 and met the inclusion and exclusion criteria,they were segmented into three groups before entering the treatment cycle based on the numerical value of DNA fragmentation index(DFI): Group A: DFI < 25%(n = 34);Group B: 25% ≤ DFI≤ 35%(n = 18);Group C: DFI> 35%(n = 11).2.Comparison of general information on the day of oocyte pick-up:age,Body mass index(BMI),Anti-mullerian hormon(AMH),Antral follicle count(AFC),basic Follicle stimulating hormone(FSH)and Luteinizing hormone(LH).3.Comparison of semen routine parameters(abstinence time,sperm concentration,total sperm motility,PR,normal sperm morphology rate)and ROS.4.Laboratory outcomes: fertilization rate,cleavage rate,available embryo rate,high-quality embryo rate,blastocyst formation rate and implantation rate.5.Clinical outcome indicators: clinical pregnancy rate,early abortion rate,delivery rate,live birth rate,number of live births,The number of stillbirths,abnormal fetuses,stillbirths,newborns and follow-up rate.Results:1.Comparison of general data: There was no significant difference in age,BMI,AMH,AFC,basic FSH and LH between the three groups(P>0.05).2.Comparison of semen routine parameters: There was no significant difference in abstinence time and sperm concentration among the three groups(P>0.05).Compared with group A,the total sperm motility,PR and normal sperm morphology rate in group B decreased slightly,with no significant difference(P>0.05).In group C,the total sperm motility,PR,and normal sperm morphology rate decreased,the discrepancy has statistical significance(P<0.01).In comparison with group B,the total sperm motility,PR,and normal sperm morphology rate decrease in group C decreased with statistical significance(P<0.05).3.Comparison of semen ROS: Compared with group A,the color of semen ROS in group B and group C is deeper,and the difference is statistically significant(P<0.01 after adjustment);Compared with group B,the semen ROS in group C was slightly deeper,but there was no statistical significance(P>0.05 after adjustment).4.Comparison of laboratory indexes: There was no obvious differences in rate of fertilization,cleavage and available embryo among the three groups(P>0.05).Compared with group A,the high-quality embryo rate and blastocyst formation rate was significantly lower in group B(P<0.05),while the implantation rate decreased slightly,but they had no statistical differerce(P>0.05).In group C,the rate of high-quality embryo,blastocyst formation and implantation all debased with statistical significance(P<0.05).Compared with group B,the rate of high-quality embryo,blastocyst formation and implantation rate in group C decreased slightly,but they had no statistical significance(P>0.05).5.Comparison of clinical outcomes:(1)clinical pregnancy rate: compared with group a,the clinical pregnancy rate in group B decreased slightly,but They has no significant difference(P>0.05).The clinical pregnancy rate in group C decreased with statistical significance(P<0.05).Compared with group B,the clinical pregnancy rate in group C decreased slightly,but the difference was not statistically significant(P>0.05).(2)Early abortion rate: Group A has 24 cycles of clinical pregnancy and 4 cycles of early abortion,accounting for 16.67%;Group B has 11 cycles of clinical pregnancy and2 cycles of early abortion,accounting for 18.19%;Group C has 4 cycles of clinical pregnancy and 1 cycle of early abortion,accounting for 25%;The early abortion rate showed an increasing trend among three groups A,B and C.(3)Delivery rate and live birth rate: The delivery rate and live birth rate decreased among three groups A,B and C in turn,but they has no significant difference among the three groups(P>0.05).(4)All three groups underwent fresh cycle transplantation,and the follow-up rate was 100%.No stillbirth,stillbirth and abnormal fetal delivery occurred.Group A delivered 25 newborns(13 males and 12 females),Group B delivered 11 newborns(3males and 8 females)and Group C delivered 3 newborns(2 males and 1 female).Conclusion:The increase of DNA damage may lead to the decrease of sperm quality,thus reducing the clinical pregnancy rate of IVF-ET/ICSI patients. |
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