Adequate ovarian follicular status does not prevent the decrease in pregnancy rates associated with high sperm DNA fragmentation
Adequate ovarian follicular status does not prevent the decrease in pregnancy rates associated with high sperm DNA fragmentation
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DOI：
10.1016/j.fertnstert.2007.02.022
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发表时间：
2008-01-01
影响因子：
6.7
通讯作者：
Fanchin, Renato
中科院分区：
文献类型：
--
作者：
Frydman, Nelly;Prisant, Nadia;Fanchin, Renato
目的：精子DNA片段在卵母细胞内的潜在修复可能会干扰DNA受损精子与胚胎着床能力之间的关系。为了排除这一因素，我们分析了精子DNA片段对卵巢功能健康女性体外受精- et结果的影响。设计：前瞻性研究。地点：法国教学医院。患者：所有117名女性年龄均小于38岁，第3天血清FSH和抑制素B水平正常，并对控制卵巢过度刺激有充分反应。干预措施：采用流式细胞术末端脱氧核苷酸转移酶介导的dUTP镍端标记法测定用于常规IVF的生精子中的DNA片段率。根据DNA片段度是否超过（高片段度[HF]， n = 52）或不超过（低片段度[LF]， n = 65）第50百分位值（35%），将周期分为两组。主要观察指标(S): D2胚胎质量、着床率和持续妊娠率。结果：HF组和LF组患者特征、原精液参数、受精率和胚胎学数据相似。HF组每ET的临床妊娠率（37.5%对62.5%）和持续妊娠率（23.5%对57.8%）和植入率（24.5%对42.4%）均低于LF组。结论：高精子DNA碎片化有利于受精和最高胚胎形态率，但与IVF-ET结果降低有关。
Objective: Potential reparation of sperm DNA fragmentation in the oocyte may disturb any relationship between DNA-damaged sperm and the implantation ability of resulting embryos. To rule out this factor, we analyzed the consequences of sperm DNA fragmentation on IVF-ET outcome in women with healthy ovarian function.Design: Prospective study.Setting: Teaching hospital, France.Patient(s): All 117 women were < 38 years old, who combined normal serum day-3 FSH and inhibin B levels with an adequate response to controlled ovarian hyperstimulation.Intervention(s): The DNA fragmentation rate was determined in the raw sperm used for conventional IVF by flow cytometric terminal deoxynucleotidyl transferase-mediated dUTP nick-end labeling assay. Cycles were sorted into two groups according to whether DNA fragmentation exceeded (high fragmentation [HF], n = 52) or did not exceed (low fragmentation [LF], n = 65) the 50th percentile of values (35%).Main Outcome Measure(S): D2 embryo quality and implantation and ongoing pregnancy rates.Result(s): Patients' characteristics, raw semen parameters, fertilization rates, and embryology data were similar in HF and LF groups. Clinical (37.5% vs. 62.5%) and ongoing (23.5% vs. 57.8%) pregnancy rates per ET and implantation rates (24.5% vs. 42.4%) were lower in the HF group than in the LF group.Conclusion(s): High sperm DNA fragmentation spares fertilization and top embryo morphology rates but is associated with decreased IVF-ET outcome.