| In the past twenty years, the incidence of infertility has been increasing worldwide due to the environmental pollution, changes of eating habits, mental stress and other factors. A study of WHO shows infertility is a widespread condition known to affect about5%-10%of all couples in the development countries and account for30%of the total number of some developing countries. According to an incomplete statistics, about10%-15%couples who are at the age of childbearing can’t give birth to a newborn in China and the number is growing year by year.Therefore some scholars have pointed out the natural ability of human fertility is threatened and damaged. Not only the sharp rise in the number of patients with infertility but the multiple and complicated etiology of infertility can reflect this issue. Even some reasons has not been found by the clinical medicinal staff namely the unexplained infertility. So, the traditional drug and operation can’t meet the requirements of patients on fertility but the coming of assisted reproductive technology(ART) for infertile couples brought to the hope.The incidence of infertility in China is about10%～15%,50%of which is caused by male factors. Recently we has known the reasons that can lead to male infertility including spermatogenic mechanism defects, congenital bilateral absence of the vas deferens, varicocele, immune factors, chromosome aberration, sexual dysfunction, cryptorchidism, infection, trauma, tumor, chemotherapy, endocrine disease. But for the clinical doctors we must face such a fact that there are still about40%male infertility unable to find the clearly cause, namely the unexplained infertility.The traditional analysis of semen is always used to determine the male fertility as the basic clinical indicator. Recently with the rapid development of ART and detection technology, routine semen analysis cannot be used as the best predictors of male fertility and about15%of the patients with male infertility semen routine examination is normal so it is necessary to explore a new evaluation index of male sterility. Lately as the development of molecular biology techniques the detective method of sperm DNA is gradually well-established. So the sperm DNA fragmentation has gained public concern in recent years and is considered to be a new index to evaluate semen quality and predict fertility. As we all known the integrity of sperm nuclear genetic of material has played an important role on the maintenance of normal male fertility and it is also related to the offspring’s health. Therefore it is important to research the condition of the sperm nuclear DNA fragmentes. Although the study of sperm DNA fragmentation is still at the explorative stage and the specific mechanism is not fully understood. But a series of researches reveals that it has tremendous value of predicating in the field of ART. This study adopts sperm chromatin dispersion experiments on139cases undergoing in vitro fertilization to detect the male sperm DNA fragments and analyze the effects of DFI on the rate of IVF fertilization, cleavage, high quality embryo, pregnancy and clinical pregnancy. So it can evaluate the value of DFI on predicting the outcomes of IVF.Objective:To investigate the effects on outcomes of IVF-ET of sperm DNA fragmentation index.Methods:Sperm DNA fragmentation index of139infertile couples participating in IVF program were analyzed by sperm chromatin dispersion(SCD) test, which were divided into three groups upon the size of Sperm DNA fragmentation index:Group A (DFI<17.6%), Group B (17.6%<DFI<30%), and Group C (DFI>30%). IVF outcomes were analyzed by one-way ANOVA, including of fertilization rate, cleavage rate, high quality embryos rate and pregnancy outcomes.Results:compared with group A, normal morphology sperm rate and sperm forward motility (a+b%) as well as cleavage rate and high quality embryos rate were reduced in group B and group C (p>0.05vs group B, p<0.05vs group C), compared with group B, normal morphology sperm rate and sperm forward motility (a+b%) as well as cleavage rate and high quality embryos rate were reduced in group C(p<0.05); compared with group A, fertilization rate was reduced in group B and group C(p<0.05vs group B, p<0.05vs group C); compared with group B, fertilization rate was reduced in group C (p<0.05), however, no statistic difference was observed on the biochemical pregnancy rate or clinical pregnancy rate in group A, group B and group C(p>0.05). Conclusion:The increase in sperm DFI can not only result in an decrease in the sperm forward motility or normal morphology rate, but also lead to a decline of IVF fertilization rate, cleavage rate, high quality embryos rate, however, outcomes of clinical pregnancy had no obvious affected. |
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