精子形态异常与体外受精移植周期助孕结局及新生儿畸形率的相关性分析

doi:10.3969/j.issn.1006-6233.2020.08.031

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摘要 目的: 评估精子形态异常对体外受精移植周期助孕结局及新生儿畸形率的影响。方法: 通过回顾性分析在2013年1月至2020年1月, 1820例在本生殖医学中心首次做体外受精移植周期助孕的患者, 通过测定其正常形态精子百分率分为三组(<1.0%、1.0~4.0%及>4.0%), 比较三组间体外受精移植周期辅助助孕结局情况, 包括临床妊娠率、抱婴率及自然流产率, 随后进一步比较三组中成功生育婴儿的安全性, 包括早产率、婴儿体重及畸形率。结果: 三组分别包含145、726和949例, 进行体外受精移植周期助孕前三组患者间的一般资料(女方年龄、体重指数、基础FSH、男方年龄及不孕年数等)无显著性差异(P>0.05), 表明结果可比性;正常形态精子百分率的大小对体外受精移植周期助孕后的临床妊娠率、抱婴率及自然流产率等结局均无显著影响;随访777例已分娩夫妇, 发现三组间的早产率及婴儿体重的差异均无统计学意义(P>0.05), 同时精子形态异常亦不会增加新生儿的畸形率。结论: 精子形态异常既不影响体外受精移植周期助孕结局(包括临床妊娠率、抱婴率及自然流产率), 也不影响新生儿的安全性(包括早产率、婴儿体重及畸形率), 为精子形态异常患者选择体外受精移植周期助孕的安全性提供一定的参考价值。

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关键词 ：精子形态, 辅助助孕, 新生儿, 畸形率

Abstract：Objective: To evaluate the effect of abnormal sperm morphology on the outcome of assisted pregnancy and the rate of neonatal deformities during the in vitro fertilization cycle. Methods: From January 2013 to January 2020, 1820 patients were selected who were accepting assisted pregnancy during the in vitro fertilization cycle for the first time in our reproductive medical center. The percentage of normal morphological sperm of patients was measured and they were divided into three groups (<1.0%, 1.0~4.0% and> 4.0%). The outcomes of assisted pregnancy among the three groups, including clinical pregnancy rate, live birth rate, and natural abortion rate, were compared. Then the safety, including preterm birth, infant weight and deformity rate, were further compared. Results: The three groups included 145, 726, and 949 cases, respectively. There was no significant difference in general information (age of women, body mass index, basic FSH, age of men and infertility years.) among the three groups before assisted pregnancy (P>0.05); the percentage of morphological sperm had no significant effect on the outcomes of assisted pregnancy, such as clinical pregnancy rate, live birth rate and spontaneous abortion rate. Follow-up of 777 deliveried couples showed that there was no statistical difference in preterm birth rate and infant weight among the three groups (P>0.05), and abnormal sperm morphology will not increase the deformity rate of the newborn. Conclusion: Abnormal sperm morphology did not affect the assisted pregnancy outcome (including clinical pregnancy rate, live birth rate and spontaneous abortion rate), nor the safety of the newborn (including premature birth, infant weight and deformity rate). The study could provide certain reference for the safety of patients with abnormal sperm morphology on selecting assisted pregnancy.

Key words： Sperm morphology Assisted pregnancy Newborn Deformity rate

基金资助:广东省科技计划项目, (编号:2014A020212035)

引用本文:

刘利敏, 吴志焕, 柯洁荣, 高彩凤, 李敦高. 精子形态异常与体外受精移植周期助孕结局及新生儿畸形率的相关性分析[J]. 河北医学, 2020, 26(8): 1367-1370.
LIU Limin, et al. An Analysis of the Impact of Abnormal Sperm Morphology on the Outcome of Assisted Pregnancy and Neonatal Deformity Rate During the in Vitro Fertilization Cycle. HeBei Med, 2020, 26(8): 1367-1370.

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http://www.hbyxzzs.cn/CN/10.3969/j.issn.1006-6233.2020.08.031 或 http://www.hbyxzzs.cn/CN/Y2020/V26/I8/1367

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