Observation of the impact of sperm DNA fragmentation index on embryonic development and clinical outcomes of intracytoplasmic sperm injection using time-lapse imagining embryo culture system
Objective To observe the impact of sperm DNA fragmentation index (DFI) on embryonic development and clinical outcomes of intracytoplasmic sperm injection (ICSI) using time-lapse imagining (TLI) embryo culture system.Method A total of 392 couples who received ICSI assisted pregnancy in the Department of Assisted Reproduction,the International Peace Maternal and Child Health Hospital,School of Medicine,Shanghai Jiao Tong University from January to June 2023 were selected as the study subjects.They were divided into 284 cycles in the conventional culture group and 108 cycles in the TLI group.According to DFI≤15％,>15％～<30％,≥30％,further divided into normal group,critical group,abnormal group.The clinical data and clinical pregnancy outcomes of all groups were compared.Statistical methods performed by t-test,one-way analysis of variance and x2 test or Fisher exact probability method.Result There were no significant differences in female age,follicle stimulating hormone (FSH),body mass index (BMI) and number of eggs harvested in the 6 groups (all P>0.05).There was no significant difference between the concentration and normal form rate of male semen (all P>0.05).The forward motility sperm rates of normal group,critical group,abnormal group in conventional group,normal group,critical group and abnormal group in TLI group were (46.5±16.5) ％,(31.0±14.2) ％,(14.8±8.4) ％,(41.6±16.2) ％,(32.5±14.4) ％ and (19.3±11.1) ％,respectively.The forward motility sperm rate in conventional normal group and TLI abnormal group was lower than that in normal group,critical group,normal group and critical group in TLI group,respectively (all P<0.05).There was no significant difference in cleavage rate and blastocyst formation rate among the 6 groups (P>0.05).The fertilization rates of normal group,critical group,abnormal group in conventional group,normal group,critical group and abnormal group in TLI group were (77.3±18.6) ％,(78.6±17.1) ％,(68.3±22.7) ％,(77.4±14.5) ％,(74.5±13.1) ％ and (63.1±25.4) ％,respectively.The fertilization rate of the conventional normal group was lower than that of the normal group,the critical group in conventional group and TLI normal group (all P<0.05).The fertilization rate of TLI abnormal group was lower than that of normal group,critical group in conventional group,normal group and critical group in TLI group (all P<0.05).The pregnancy rates of the normal group,the critical group and the abnormal group were 57.4％ (39/68),54.5％ (24/44) and 27.3％ (6/22),respectively.The abnormal group was lower than the normal group and the critical group (all P<0.05).There was no significant difference in pregnancy rate among normal group,critical group and abnormal group in TLI group (P>0.05).There was no significant difference in the early abortion rate between the conventional group and the TLI 3 groups (P>0.05).Conclusion The increase of sperm DFI value will affect the forward movement rate of sperm,and also affect the fertilization rate of embryos.A stable pregnancy rate can be achieved by using the TLI embryo culture system during ICSI assisted pregnancy with high DFI sperm.
万方数据
维普
