Fall in implantation rates following ICSI with sperm with high DNA fragmentation
Fall in implantation rates following ICSI with sperm with high DNA fragmentation
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DOI：
10.1093/humrep/deq116
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发表时间：
2010-07-01
影响因子：
6.1
通讯作者：
Serhal, P.
中科院分区：
文献类型：
--
作者：
Speyer, B. E.;Pizzey, A. R.;Serhal, P.
背景技术背景：高精子DNA片段化指数（DFI）对成功妊娠的意义存在相当大的不确定性。方法：采用精子染色质结构分析法测定124例接受192个IVF周期和96例接受155个ICSI周期患者的精子DFI。ICSI周期的继续妊娠率与DFI值呈显著负相关（r = 0.184，P = 0.022），IVF周期的继续妊娠率与DFI值无相关性。ICSI周期的DFI阈值>= 19%，而IVF周期的DFI阈值无显著性差异（P = 0.005）。然而，如果IVF周期使用>= 30%的阈值，则在较高的DFI水平下继续妊娠和植入率无显著降低。DFI水平对受精率或受精后第3天具有4个以上细胞的胚胎的百分比没有影响。高DFI水平对ICSI周期的着床率有显着影响（P = 0.001），但对IVF周期的着床率无显着影响。一个显着的正相关性（r = 0.268，P = 0.001）之间DFI和精子中段缺陷也注意到在ICSI patients.CONCLUSIONS：这些观察可能有助于解决的问题，如何，以及在何种程度上，精子DNA损伤后IVF和ICSI程序的成功影响。
BACKGROUND: There is considerable uncertainty as to the significance of a high sperm DNA fragmentation index (DFI) for achieving a successful pregnancy.METHODS: The sperm DFI of 124 patients undergoing 192 IVF cycles and of 96 patients undergoing 155 ICSI cycles was determined using the sperm chromatin structure assay on neat sperm.RESULTS: The rate of continuing pregnancies in ICSI cycles (but not in IVF cycles) showed significant negative correlation (r = 0.184, P = 0.022) with the DFI value. A threshold value of DFI which showed a significant difference (P = 0.005) in rate of continuing pregnancies between higher and lower DFI levels was found for ICSI cycles to be >= 19%, but no such threshold was found for IVF cycles. However, if the threshold of >= 30% was used for IVF cycles there was a non-significant lowering of the rates of continuing pregnancy and implantation at the higher DFI levels. DFI level had no effect on fertilization rate or on the percentage of embryos having more than 4 cells at Day 3 after fertilization. A high DFI level had a marked significant effect (P = 0.001) on implantation rate in ICSI cycles but not in IVF cycles. A significant positive correlation (r = 0.268, P = 0.001) between DFI and sperm midpiece defects was also noted in the ICSI patients.CONCLUSIONS: These observations may help to resolve the issues about how, and to what extent, sperm DNA damage impacts upon the success of IVF and ICSI procedures.