Objective To investigate the correlation between male sperm deformity rate and DNA integrity and recurrent spontaneous abortion.Methods Forty-five patients with recurrent spontaneous abortion and their husbands who were admitted to the Affiliated Hospital of North Sichuan Medical College from August 2019 to August 2021 were selected as the recurrent abortion group,and another 45 parturients and their husbands who were documented and examined during the same period in the Affiliated Hospital of North Sichuan Medical College were selected as the normal pregnancy group.The age,body mass index(BMI),number of abortions,uterine status(such as intrauterine adhesions,endometrial polyps,incomplete septum,normal),combined hypertension,and combined diabetes were recorded for female subjects in the two groups.After abstinence for 2 to 7 days,all the excreted semen of the 90 male subjects were collected by extracorporeal sperm collection.The semen volume,pH value,total sperm motility,forward motile sperm(PR)percentage,and sperm concentration of male subjects in the two groups were detected by using an automatic sperm quality analyzer.The sperm morphology was observed by using the Diff-Quik method,and the sperm deformity rate was calculated.The sperm DNA fragmentation index of male subjects in the two groups was calculated by using a flow cytometry-based sperm chromatin structure analysis method.The semen volume,pH value,PR percentage,total sperm motility,sperm concentration,sperm deformity rate,and sperm DNA fragmentation index of male subjects between the two groups were compared.The male subjects in the recurrent abortion group were subjected to density gradient centrifugation for sperm selection,and the changes in semen volume,pH value,PR percentage,total sperm motility,sperm concentration,sperm deformity rate,and sperm DNA fragmentation index before and after sperm selection were compared.Intrauterine insemination was performed and the clinical pregnancy was recorded in the recurrent abortion group.The double correlated variable Spearman was used to analyze the relationship between the male's total sperm motility,PR percentage,sperm concentration,sperm deformity rate,sperm DNA integrity and the occurrence of recurrent spontaneous abortion.Results There was no statistically significant difference in age,BMI,uterine status,proportions of combined hypertension and diabetes for female subjects between the recurrent abortion group and the normal pregnancy group(P＞0.05).The PR percentage,total sperm motility and sperm concentration of male subjects in the recurrent abortion group were significantly lower than those in the normal pregnancy group(P＜0.05);there was no statistically significant difference in semen volume and pH value of male subjects between the recurrent abortion group and the normal pregnancy group(P＞0.05).The sperm head deformity rate and the total sperm deformity rate of male subjects in the recurrent abortion group were significantly higher than those in the normal pregnancy group(P＜0.05).There was no statistically significant difference in the incidences of sperm body deformity and tail deformity of male subjects between the recurrent abortion group and the normal pregnancy group(P＞0.05).The sperm DNA fragmentation index of male subjects in the recurrent abortion group and the normal pregnancy group was(18.78±4.41)％and(12.78±5.85)％,respectively.The sperm DNA fragmentation index in the recurrent abortion group was significantly higher than that in the normal pregnancy group(t=11.352,P＜0.001).The double correlated variable Spearman analysis showed that the total sperm motility,PR percentage and sperm concentration were negatively correlated with recurrent spontaneous abortion(r=-0556,-0.551,-0.494;P＜0.05),while the total sperm deformity rate and sperm DNA fragmentation index were positively correlated with recurrent spontaneous abortion(r=0.551,0.498;P＜0.05).After sperm selection,the sperm head abnormality rate,sperm body abnormality rate,total sperm deformity rate,and sperm DNA fragmentation index of male subjects in the recurrent abortion group were significantly lower than those before sperm selection(P＜0.05).There was no statistically significant difference in the sperm tail deformity rate of male subjects before and after sperm selection in the recurrent abortion group(P＞0.05).Of the 45 patients with recurrent spontaneous abortion,10 patients(22.22％)were clinically pregnant,including 2 full-term births and 8 premature births.Conclusion Male sperm deformity rate and DNA integrity have positive correlation with recurrent spontaneous abortion.Clinically,sperm selection can improve sperm DNA integrity and reduce sperm deformity rate to increase the probability of normal pregnancy after artificial insemination.
维普
万方数据
