| Objective:Through semen and Sperm DNA fragmentation index(DFI)were routinely tested for Infertile men in vitro fertilization-embryo transfer(IVF-ET)and intracytoplasmic sperm injection(ICSI-ET)assisted pregnancy treatment from the Reproductive Center of Northwest Women and Children’s Hospital.Discussion:(1)Correlation between sperm DNA fragmentation index and semen parameters;(2)Correlation between sperm DNA fragmentation index and IVF/ICSI-ET outcome.Methods:Etection of semen routine for infertile males among 927 couples(1167ovum retrieval cycles)who needed to receive assisted reproduction technology(ART)for pregnancy for the first time in the reproductive center of Northwest Women’s and Children’s Hospital from February 2014 to October 2018,and detect sperm DFI for sperm chromatin structure analysis method.According to the size of sperm DFI value is divided into three groups(Group A DFI≤15%,Group B 15%<DFI<30%,Group C DFI≥30%),and then analysis on the three groups of semen routine parameters,IVF/ICSI assisted primary clinical outcomes(cumulative live birth rate)and secondary clinical outcomes(implantation rate,β-HCG positive rate,clinical pregnancy rate,early abortion rate).Results:(1)Comparison of the general situation of female patients in different DFI groups:the female age of group B is greater than that of group A,the difference between the two groups is statistically significant(P<0.05),and The difference was not statistically significant between the age of group C and group A,and between group C and group B(P>0.05);the comparison of infertility factors between groups(female factor,male factor,bilateral factor,other factors)was statistically significant(P<0.05).There was no statistically significant difference in the body mass index,follicle stimulating hormone,number of sinus follicles,infertility years,infertility type,and smoking among women in each group(P>0.05).(2)Comparison of ovulation induction among patients with different DFI groups:There are significant differences in fertilization methods(IVF,ICSI)between the groups(P<0.001);the ovulation induction program,the total number of days of gonadotropin(Gn),gonadotropin in each group There was no statistically significant difference in the total amount of hormones(Gn),the number of ovum harvested,the number of fertilizations,the number of cleavages,the number of 2PN,the number of high-quality embryos on D3,the number of embryos available on D3,and the cleavage rate(P>0.05).(3)There is a statistically significant difference between the age of the men under40 years old in group A(31.04±33.5)and group B(32.00±3.57),group A(31.04±33.5)and group C(32.71±3.25),(P<0.05),There is no statistically significant difference between the ages of the men in Group B and Group C(P>0.05).There were significant statistical differences between 40 years old or older,the male smoking,semen concentration,sperm viability,and percentage of normal sperm morphology in each group(P<0.001).The semen concentration and sperm in group A The survival rate and percentage of normal sperm morphology were the highest,followed by group B,and the lowest in group C.There was no statistical difference between body mass index,days of abstinence,liquefaction time,semen PH,and semen volume(P>0.05).(4)Comparison of IVF/ICSI assisted pregnancy outcomes in different DFI groups:there was no significant statistical difference among rimary pregnancy outcomes(cumulative live birth rate),secondary pregnancy outcomes(implantation rate,β-HCG positive rate,clinical pregnancy rate,early miscarriage rate,ectopic pregnancy rate)(P>0.05).(5)Multi-factor logistic regression analysis of the main pregnancy outcome(cumulative live birth rate):a binary logistic regression analysis regression model was constructed by the forward method,and the Hosmer and Lemeshow test fitχ~2 statistical value of the model was 10.24(P=0.249),indicating that the model can fit the data well(P>0.05),Excluding confounding factors such as female age,male age,infertility factors,fertilization methods,male smoking,sperm concentration,sperm viability and normal sperm morphology,the results showed that male infertility factors(OR=0.602,95%CI0.423-0.858,P=0.005)has a significant effect on the cumulative live birth rate,after excluding confounding factors,the DFI group(OR=0.759,95%CI 0.536-1.076,P=0.121)has no significant effect on the cumulative live birth rate,and the remaining variables have an effect on the cumulative live birth rate.See table 3.5Conclusion:Sperm DFI is negatively correlated with semen concentration,sperm viability,and normal sperm morphology,but not with semen volume.There is no obvious correlation between the sperm DFI and IVF/ICSI-ET live birth rate(/ovum retrieval cycle),implantation rate,β-HCG positive rate,clinical pregnancy rate,early miscarriage rate. |
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