精子DNA碎片化对不同年龄女性行体外受精-胚胎移植助孕胚胎质量及妊娠结局的影响

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中文摘要：目的探索精子DNA碎片化对不同年龄女性行体外受精-胚胎移植(IVF-ET)助孕胚胎质量和妊娠结局的影响。方法回顾性分析2019年1月-2022年12月在厦门大学附属妇女儿童医院进行IVF-ET助孕的3 053个取卵周期患者的临床资料。根据男方精子DNA碎片化指数(DFI)不同将患者分为正常DFI组(DFI＜30％)和高DFI组(DFI≥30％);并根据女方年龄分为＜35岁和≥35岁进行分层分析。比较各组患者的总受精率、正常受精率、优质胚胎率、囊胚形成率、优质囊胚率、生化妊娠率、种植率、临床妊娠率、流产率及活产率。结果当女方年龄＜35岁时，高DFI组的男方年龄[(33。10±4。35)岁]显著高于正常DFI组[(31。14±3。50)岁]，差异有统计学意义(t=-4。95，P＜0。05)，精子活力[(33。94±15。96)％]、正常精子形态率[(10。03±4。21)％]均显著低于正常DFI组[(48。80±15。35)％、(11。54±4。62)％]，差异均有统计学意义(t=10。47、3。26，均P＜0。05)，高DFI组的优质胚胎率(23。3％)、囊胚形成率(67。3％)及优质囊胚率(14。4％)均显著低于正常DFI组(27。7％、70。8％及20。2％)，差异均有统计学意义(x2=13。00、5。50及13。26，均P＜0。05)。当女方年龄≥35岁时，高DFI组的可移植胚胎数显著低于正常DFI组，差异有统计学意义(P＜0。05)，总受精率(73。0％)、正常受精率(59。7％)及囊胚形成率(55。5％)均显著低于正常DFI组(78。0％、65。8％及67。3％)，差异均有统计学意义(x2=7。75、8。97及13。75，均P＜0。05)，高DFI组的流产率(35。0％)显著高于正常DFI组(20。8％)，差异有统计学意义(x2=4。01，P＜0。05)。其余各组生化妊娠率、种植率、临床妊娠率及活产率比较，差异均无统计学意义(均P＞0。05)。结论精子DNA碎片化对不同年龄女性行IVF-ET助孕的胚胎质量产生负面影响，虽然对妊娠和活产结局的影响并不显著，但其可能增加高龄女性的流产风险。

外文标题：Effect of sperm DNA fragmentation on the embryo quality and pregnancy outcomes in different female ages undergoing IVF-ET

外文摘要：Objective The study aims to investigate the implications of sperm DNA fragmentation on embryo quality and pregnancy out-comes in different female ages undergoing IVF-ET.Methods Performed a retrospective analysis of clinical data from 3 053 cycles that under-went IVF-ET at Women and Children's Hospital,School of Medicine,Xiamen University,from January 2019 to December 2022.Participants were categorized into two groups based on the male partner's sperm DFI:a normal DFI group(DFI＜30％)and a high DFI group(DFI ≥30％).Further stratification was carried out based on the age of the female participant(＜35 years old and ≥35 years old).Outcome meas-ures included total fertilization rate,normal fertilization rate,high-quality embryo rate,blastocyst formation rate,high-quality blastocyst rate,biochemical pregnancy rate,implantation rate,clinical pregnancy rate,abortion rate,and live birth rate.Results When the female age was＜35 years old,the male age in the high DFI group[(33.10±4.35)years]was significantly higher than that in the normal DFI group[(31.14±3.50)years](t=-4.95,P＜0.05),sperm vitality(33.94±15.96)％and normal sperm morphology rate(10.03±4.21)％were significantly lower than those in normal DFI group[(48.80±15.35)％,(11.54±4.62)％](t=10.47,3.26,all P＜0.05),the high-quality embryo rate(23.3％),blastocyst formation rate(67.3％)and high-quality blastocyst rate(14.4％)in high DFI group were significantly lower than those in normal DFI group(27.7％,70.8％and 20.2％)(x2=13.00,5.50 and 13.26,all P＜0.05).When the female age was ≥ 35 years old,the number of transplantable embryos in high DFI group was significantly lower than that in normal DFI group(P＜0.05),the total fertilization rate(73.0％),normal fertilization rate(59.7％)and blastocyst formation rate(55.5％)in high DFI group were significantly lower than those in normal DFI group(78.0％,65.8％and 67.3％)(x2=7.75,8.97 and 13.75,all P＜0.05),the abortion rate in high DFI group(35.0％)was significantly higher than that in normal DFI group(20.8％)(x2=4.01,P＜0.05).No significant differences were observed between groups for biochemical pregnancy rate,implantation rate,clinical pregnancy rate,and live birth rate(P＞0.05).Conclusion DFI exerts adverse effects on embryo quality in IVF-ET among women of varying ages.Although it doesn't markedly influence pregnancy and live birth outcomes,it may increase the risk of miscarriage in older women.

外文关键词：

Sperm DNA FragmentationIVF-ETEmbryo Quali-tyLive Birth Rate

作者：

施祝贤、王桂泉、李萍

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作者单位：

厦门大学附属妇女儿童医院(厦门市妇幼保健院)生殖医学科厦门市生殖与遗传重点实验室,福建厦门 361003

关键词：

精子DNA碎片化体外受精-胚胎移植胚胎质量活产率

出版年：

2025

DOI：