不育男性精子形态与体外受精妊娠结局的相关性研究

摘要

Objective To investigate the correlation between sperm morphology in male infertility and ultimate pregnancy with IVF. Methods 573 cases of sperm morphology of infertile males were measured and analyzed according to the WHO laboratory handbook about human semen. All the cases were divided into two groups by the rate of normal sperm morphology according to the WHO laboratory handbook (<15%: =S 15%). The IVF group consisted of 327 cases and intracytoplasmic sperm injection(ICSI) was given to 246 cases. The fertilization rate, cleavage rate, good quality embryo rate, pregnancy rate and abortion rate between the two groups were analyzed and discussed. Results There was a significant difference between the two groups in the fertilization rate, cleavage rate, good quality embryo rate and pregnancy rate (.P<0.05) during the IVF cycles, but no significant difference was noted in the abortion rate (P> 0.05). There was no significant difference between the two groups in the above-mentioned index during the ICSI - cycles (P>0.05). Conclusion Sperm morphology affects the ultimate result of the IVF cycles. There is no.significant influence of sperm morphology on the outcome of the ICSI cycles. ICSI is an optimal choice for people with abnormal morphological sperms.%目的 探讨不育男性精子形态与体外受精妊娠结局的关系.方法 按照WHO《人类精液及精子-宫颈粘液相互作用实验室检验手册》要求对573例接受辅助生殖技术治疗的男性不育患者的精子形态进行分析,根据患者正常精子形态百分比分为2组(＜1 5％:≥1 5％),分别采用体外受精(IVF)或卵泡浆内单精子注射(ICSI)的受精方式,观察精子形态对IVF及ICSI的受精率、卵裂率、优质胚胎率、妊娠率和流产率等的影响.结果采用IVF(327例)受精方式下,两形态组精子的受精率、卵裂率、优质胚胎率和妊娠率差异均有统计学意义(P＜0.05),但流产率差异无统计学意义(P＞0.05)；而采用ICSI(246例)受精方式下,两形态组精子的上述指标比较差异均无统计学意义(P＞ 0.05).结论不育男性精子形态异常影响IVF治疗结局,但对ICSI治疗结局无影响,对于精子形态异常的患者应采用ICSI的受精方式.