不同处理方法优选精子效果的比较

摘要

Objective: To evaluate the results of different sperm selection methods ( swim-up, washing-centrifugation and three gradient centrifugation protocols).Methods: Each of 44 semen samples was divided into five equal parts (in 0. 5 ml aliquot) and processed with swim-up, washing-centrifugation and three different protocols of density gradient centrifugation protocols (Sperm Grad, Pure Sperm and Pure Ception), respectively. The concentration, motility, abnormality rate, sperm deformity index (SDI) and DNA fragmentation index (DFI) of the resultant sperm were detected and compared among the five methods.Results; The sperm concentration, the values of SDI and DFI, percentages of abnormal sperm and head/neck/tail abnormality were significantly higher (P<0. 05) and motility was significantly lower (P< 0.05) with washing centrifugation method than with swim-up method or density gradient centrifugation methods. The value of DFI and sperm concentration were lower and the sperm motility was higher with swim-up method than with gradient centrifugation (P<0. 05), but SDI value, percentages of abnormal sperm and head/neck/tail abnormality showed no significant difference between two methods (P>0. 05). There was no significant difference in sperm concentration, motility, abnormality, SDI or DFI among three gradient centrifugation protocols (P>0. 05), but the head abnormality in group of Pure Sperm and theneck abnormality in group of Pure Ception were significantly higher than in other gradient centrifugation groups (P<0. 05).Conclusions: Swim-up might be the best sperm selection method for normal sperm sample due to the highest motility, the lowest abnormality and DFI value, and appropriate sperm concentration. Three gradient centrifugation protocols could be suitable for processing the semen sample with severely lower concentration.%目的 比较上游法、三种密度梯度离心法和洗涤离心法优选精子的效果. 方法 门诊收集浓度与活力正常的精液标本44份,每份精液各取0.5 ml×5,分别采用上游法、密度梯度离心法和洗涤离心法进行处理,比较各组的精子浓度、活力、畸形率、精子畸形指数(SDI)和DNA碎片指数(DFI),再按试剂来源将密度梯度离心法分为Sperm Grad梯度离心组(A组)、Pure Sperm梯度离心组(B组)和Pure Ception梯度离心组(C组),进行上述参数比较. 结果与上游法和梯度离心法相比,洗涤离心法精子浓度、DFI值、畸形率、SDI值及头部、中段、尾部畸形率均显著增高(P＜0.05),活力显著降低(P＜0.05)；与梯度离心法相比,上游法精子浓度、DFI值均显著降低(P＜0.05),活力显著升高(P＜0.05),两组间总畸形率、SDI值及头部、中段、尾部畸形率均无显著性差异(P＞0.05).A、B、C组间精子浓度、活力、畸形率、SDI及DFI等参数均无显著性差异(P＞0.05),但C组中段畸形率显著高于A组和B组(P＜0.05),B组尾部畸形率显著高于A组和C组(P＜0.05)； 结论对于精子浓度和活力正常的精液标本,上游法精子活力最高、畸形率和DFI值最低,且精子浓度能够满足临床需要,是较为理想的精子优选技术；三种不同梯度离心法优选精子效果无显著性差异,适用于严重少精子症精液标本的处理.