目的：探讨体外受精（IVF）技术中精子处理前后常规参数与受精率的关系。方法选择2011年6月到2013年3月在南华星辉生殖健康专科医院行IVF助孕的285个鲜胚周期，将这285个周期分为受精率≤40%组（A组）和受精率＞40%组（B组），分别比较两组处理前无A级精子比例、上游法回收率≤5%比例、处理后前向运动（PR）总数＜1.0×106比例、精子巴氏染色正常形态＜4%比例、精子顶体酶活性＜48.2μIU/106精子比例的差异。结果 A、B两组处理前无A级精子比例（分别为14.7%和0.4%，P＜0.05）、上游法回收率≤5%比例（分别为23.5%和0.8%，P ＜0.05）、处理后PR总数＜1.0×106比例（分别为17.6%和0%，P ＜0.05）均具有显著性差异（P＜0.05）；精子巴氏染色＜4%（分别为11.8%和10.0%）、顶体酶活性＜48.2μIU /106精子（5.9%和2.4%）均无显著性差异。结论处理前无A级精子、上游法回收率≤5%和处理后PR总数＜1.0×106是影响受精率的高危因素；精子巴氏染色＜4%和精子顶体酶活性低对预测IVF受精率具有一定局限性。%Objective To study the relationship between the general parameters of sperm and the fertilization rate of IVF. Methods A total of 285 IVF cycles were collected from Nanhua Xinghui Reproductive Health Hospital from June 2011 to March 2013. The 285 cycles were divided into group A (the fertilization rate of IVF ≤40%) andgroup B (the fertilization rate of IVF >40%). The percentage of without A grade sperm before preparation, the percentage of the recovery of sperm swim-up≤5%, the percentage of the total PR sperm after preparation <1.0×106, the percentage of normal sperm morphology of papanicolaous stain<4% and sperm acrosin activity<48.2MIU/106 were analyzed respectively. Results Between the two groups there were significant difference in the percentage of without A grade sperm before preparation (14.7% VS. 0.4%,P<0.05), the percentage of the recovery of sperm swim-up≤5%(23.5% VS.0.8%,P<0.05), the percentage of the total PR after preparation<1.0×106 (17.6% VS.0%,P<0.05) , and there were not significant changes in the percentage of normal sperm morphology of papanicolaous stain<4% (11.8% VS.10.0%), the percentage of sperm acrosin activity <48.2 MIU/106 (5.9% VS.2.4%). Conclusion Without A grade sperm before preparation, the recovery of sperm swim-up≤5%and the total PR after preparation <1.0×106 were significantly associated with the fertility rate of IVF. Whereas, sperm morphology of papanicolaous stain and sperm acrosin activity showed some limition in predicting the fertility rate of IVF.
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