| Objective:To explore the effects of sperm acrosin activity and different fertilization methods(IUI/IVF/ICSI)on pregnancy outcome in infertile couples receiving assisted reproductive technology(ART).Guide infertile couples to choose appropriate assisted reproductive technology to obtain better pregnancy outcome.Methods:The infertile couples who received IUI/IVF/ICSI treatment in our reproductive center for 398 cycles from January 2019 to March 2020 were selected to retrospectively analyze their general data,sperm laboratory data,embryo laboratory data and clinical pregnancy outcome follow-up data.These included 190 cycles of IUI,167 cycles of IVF,and 41 cycles of ICSI.The sperm acrosin activity(SAA)was determined by the SAA assay kit(solid phase BAPNA method)to evaluate whether the SAA was normal or not.According to the SAA,it was divided into 2 groups:Group A:SAA≥64.9μIU/10~6sperm,Group B:SAA<64.9μIU/10~6sperm.IBM SPSS 23.0 software was used to analyze the experimental date collected previously.To investigate the effects of SAA and different fertilization methods(IUI/IVF/ICSI)on the pregnancy outcome of infertile couples undergoing ART in each cycle.Results:1.Couples who received ART(IUI/IVF/ICSI)in this study had a total of 398 cycles,303 cycles in group A and 95 cycles in group B.There were statistical significant (P<0.05)in male age(P=0.047),sperm concentration(P=0.000),sperm count (P=0.000),forward motility rate of sperm(P=0.037),total number of forward motility of sperm(P=0.000),normal morphology rate of sperm(P=0.005),survival rate of sperm(P=0.036)among the two groups.There were no statistical differences(P>0.05)in length of abstinence and sperm DNA integrity among the two groups.2.Couples who received IUI treatment in this study had a total of 190 cycles,143cycles in group A1 and 43 cycles in group B1.There were no statistical differences(P>0.05)in clinical pregnancy rate,biochemical pregnancy rate,live birth rate,abortion rate,among the two groups.3.Couples who received IVF treatment in this study had a total of 167 cycles,137 cycles in group A2 and 30 cycles in group B2.There were statistical significant(P<0.05)in fertilization rate(χ~2=26.119,P=0.000),high-quality embryo rate(χ~2=5.706,P=0.017),transplantable embryo rate(χ~2=12.861,P=0.000)among the two groups.There were no statistical differences(P>0.05)in cleavage rate,biochemical pregnancy rate,clinical pregnancy rate,abortion rate、live birth rate among the two groups.4.Couples who received ICSI treatment in this study had a total of 41 cycles,23 cycles in group A3 and 18 cycles in group B3.There were statistical significant(P<0.05)in fertilization rate(χ~2=4.427,P=0.035),transplantable embryo rate(χ~2=9.077,P=0.003)among the two groups.There were no statistical differences(P>0.05)in cleavage rate,biochemical pregnancy rate,clinical pregnancy rate,live birth rate,abortion rate,high quality embryo rate among the two groups.6.When the SAA≥64.9μIU/10~6sperm,biochemical pregnancy rate(χ2=47.159,P=0.000),clinical pregnancy rate(χ2=44.262,P=0.000),live birth rate(χ2=42.019,P=0.000)of IVF group,and biochemical pregnancy rate(χ2=16.185,P=0.000),clinical pregnancy rate(χ2=17.000,P=0.000),live birth rate(χ2=16.203,P=0.000)of ICSI group were obviously higher than IUI group,which were statistical significant (P<0.05).There were no significant differences(P>0.05)in fertilization rate,egg row rate,high quality embryo rate and transplantable embryo rate between IVF group and ICSI group.There was no significant difference in the abortion rate among the three groups(P>0.05).7.When the SAA<64.9μIU/10~6sperm,biochemical pregnancy rate(χ2=9.205,P=0.003),clinical pregnancy rate(χ2=7.582,P=0.012),live birth rate(χ2=6.013, P=0.014)of IVF group and biochemical pregnancy rate(χ2=5.551,P=0.034),live birth rate(χ2=4.768,P=0.029)of group ICSI were obviously higher than IUI group,which were statistical significant(P<0.05).There was no significant difference in the abortion rate among the three groups(P>0.05).There were also no significant differences (P>0.05)in fertilization rate,egg row rate,high quality embryo rate and transplantable embryo rate between IVF group and ICSI group.Conclusions:1.Sperm acrosin activity was negatively correlated with male age.2.Sperm acrosin activity was positively correlated with sperm concentration,sperm total number,sperm forward motility rate,sperm total number of forward motility,sperm normal morphology rate and sperm survival rate.It was negatively correlated with abnormal sperm index.However,there was no significant correlation with the sperm DNA integrity.3.When the sperm acrosin activity decreased,the fertility rate,and transferable embryo rate are also decreased,and the performance was more obvious in IVF than in IUI and ICSI.So the sperm acrosin activity was used to predict the fertilization outcome of assisted reproductive technology4.There was no significant correlation between the sperm acrosin activity and biochemical pregnancy rate,clinical pregnancy rate,living yield rate and abortion rate.Therefore,the prediction of them is low.5.When the semen routine parameters were low and the sperm acrosin activity was normal,IVF treatment can be preferentially selected after comprehensive consideration;When the sperm acrosin activity was low,ICSI can be preferentially selected. |
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