【作者】 王艳红；

【导师】 田秀珠；

【作者基本信息】 山西医科大学 ， 妇产科学（专业学位）， 2018， 硕士

【摘要】 目的:探讨女方促排卵前男方精子形态参数对常规体外受精-胚胎移植(In Vitro Fertilization-Embryo Transfer,IVF-ET)妊娠结局的预测价值和影响。方法:选取502对行常规IVF-ET助孕的夫妇,按照女方促排卵前3个月内男方的精液常规中正常精子形态百分率(Normal Sperm Morphology Rate,NSMR)进行分组,分别为A组:NSMR<4%,B组:4%≤NSMR<15%,C组:NSMR≥15%,比较三组间的精子其它功能参数和其IVF-ET周期中的受精率、正常受精率、卵裂率、优质胚胎形成率、胚胎种植率和妊娠率等指标差异有无统计学意义。结果:1.三组间精液体积无差异(P>0.05),但精子密度和精子活力差异有显著性(P<0.01);2.三组间的受精率、正常受精率、卵裂率、优质胚胎形成率和胚胎种植率等指标差异均无显著性(P>0.05),仅发现NSMR<4%组的受精率略低于其它两组,而NSMR≥15%组的正常受精率略高于其它两组;3.三组间的生化与临床妊娠率、异位妊娠率、早期与晚期流产率和活产率等均无显著性差异(P>0.05),仅发现随着NSMR的增加,其早期流产率呈逐渐下降趋势。结论:精子形态与精子功能关系密切,随着NSMR的增加,精子密度和精子活力会明显增加;通过精子形态这一单一指标来预测IVF-ET妊娠结局有一定的局限性。更多还原

【Abstract】 Objective:To study the predictive value and effects of the sperm morphological parameters on the pregnancy outcome of normal in vitro fertilization embryo transfer(IVF-ET)before ovulation induction.Methods:502 pairs of couples who received routine IVF-ET assisted pregnancy were selected and divided into into three groups according to normal sperm morphology rate in the 3 months before ovulation induction: Group A: NSMR< 4%,Group B: 4%≤NSMR<15% and Group C: NSMR ≥15%;and then compare the functional parameters of different groups of sperm and their fertilization rates,normal fertilization rates,cleavage rates,good-quality embryo rates,implantation rates and pregnancy rates during the IVF-ET process.Result:1.No differences in semen volumes between the three groups(P>0.05),but significant differences in sperm density and vitality(P<0.01);2.No apparent differences in fertilization rates,normal fertilization rates,cleavage rates,good-quality embryo rates and implantation rates(P>0.05),only the fertilization rates of Group A are slightly lower than those of other two groups,whereas the normal fertilization rates of Group C are slightly higher than those of other two groups;3.No significant differences in biological and clinical pregnancy rates,ectopic pregnancy rates,early and late abortion rates,and live birth rates(P>0.05).However,the rate of early abortion decreased with the increase of NSMR.Conclusion:The morphology of sperm is closely related with its functions,with the increase of the normal sperm morphology rate,the semen density and vitality increased significantly.Prediction of the pregnancy outcome of IVF-ET merely by sperm morphology is not entirely reliable.更多还原