| Aim:It's controversial whether long Y chromsome had harm effects on reproduction. The first chapter of this thesis is compared the clinical follow-up after assisted reproduction technique by sperm donors with and without long Y chromsome. Sperm chromatin is the carrier of genetic information, and the integrity of sperm chromatin is vital for normal fertilization, embryo development, and successful pregnancy. But it's disputable on the sperm chromatin structure assay for the clinical significance. The aim of chapter two is to study the relationship the sperm chromatin structure analysis parameters and assisted reproduction techniques outcome.Methods:The study contained two chapters. The first chapter, we studied all records of pregnancies including pregnancies, fetal loss, congenital malformation by human sperm donors after artificial insemination or in vitro fertilization at our hospital from Jan 2004 to Jan 2008. There are 1186 sperm donors, and 694 was engaged in AID treatment (53 with long Y chromosome),492 engaged Donor IVF-ET treatment (22 with long Y chromosome). In the AID department, a total of 2885 pregnancies were obtained after 13,089 treatment cycles. In observation group (238 pregnancies obtained after 1112 treatment cycles), there are 210 deliveries,28 fetal losses (11.8%) and 1 (0.47%) with congenital defects. In control group (2647 pregnancies obtained after 11977 treatment cycles), there were 2295 deliveries,352 (13.3%) fetal losses and 12 (0.51%) with congenital defects. In the IVF department, a total of 1587 pregnancies occurred after 2619 treatment cycles. In observation group (72 pregnancies occurred after 104 treatment cycles), there were 69 deliveries,3 (4.2%) fetal losses and 1 (1.11%) congenital defects. In control group (1674 pregnancies occurred after 2515 treatment cycles), there were 1518 deliveries,156 (10.3%) fetal losses and 16 (0.82%) congenital defects.In the first part of second chapter,148 couples receiving IVF-ET treatment including fertilization rate, good embryo rate, pregnancy outcome, and compared with sperm regular parameters, sperm morphology, acrosin activity, sperm chromatin structure analysis, chromomycin A3. In the second part of second chapter, collecting 93 semen from sperm bank donors for sperm chromatin structure analysis, and compared it with sperm donor fecundity index.Results:In the first chapter, the rates of fetal loss, congenital malformation and donor fecundity in the observation group after both assisted reproductive technique were no significant difference for the control group. In the first part of chapter two, the DFI and CMA3 positivity have no relationship with fertilization rate, only the sperm concentration is positively related; the good embryo rate is negatively related with DFI and CMA3. In the groups of achieved pregnancy and failed to achieve pregnancy, the DFI is 11.65%±6.34% and 18.24%±6.99 %(P<0.01), CMA3 positivity is 33.82%±13.07% and 39.04%±16.69% (P<0.05), good embryo rate is 66.68%±22.38% and 53.75%±24.95%(P <0.05), fertilization rate is 65.73±21.04% and 51.46±26.76%(P<0.01), respectively. In the second part of chapter two, the DFI of sperm donor is negative related with sperm donor fecundity index (r=-0.324, p=0.002).Conclusions:Long Y chromosome maybe considered as a normal variant, and has no relationship with adverse pregnancy, so we can ease the psychological burden of the patients with long Y chromsome in the genetic counseling clinic, and we can accept the potential sperm donors with long Y chromosome. Sperm chromatin integrity is closely related with male fecundity, and the good embryo rate is negatively related with DFI. So the detection of DNA fragmentation is recommended before assisted reproduction technique, and oral drugs maybe help to reduce it to improve the safty and efficacy of ART. |
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