影响供精者生育能力的相关因素分析

发布时间：2018-09-11 12:07

【摘要】： 现今，供精人工授精(AID)已成为一种常规的治疗方法，为许多不孕不育的夫妇解决了生育问题。AID的临床实践证明，不同的供精者精液使妇女受孕的能力各异，表现为周期妊娠率差异显著。导致这一差别的重要原因是供精者生育能力的个体差异，因此，分析供精者的生育能力具有重要的意义。目的：探讨用于供精人工授精(AID)治疗的冷冻精液对供精者生育能力的影响，为男性生育能力的评价提供新的指标，，也为更好的筛查供精者和提高AID的临床妊娠率提供依据。方法：1、回顾我院数据库管理系统资料，以2001年至2006年为年限，选取50例用于AID的供精者精液标本，统计其周期妊娠率(周期妊娠率=妊娠个数／周期数)及精液常规指标，以周期妊娠率作为供精者生育能力的判断标准，分析精液常规指标与周期妊娠率的关系。2、利用Annexin V—FITC流式检测、TUNEL检测、精子染色质结构分析等方法，分析50份冷冻精液精子膜的完整性、DNA碎片值以及染色质结构与周期妊娠率的关系。结果：1、周期妊娠率与精子的正常形态率、冻后活率、冻后前向运动精子总数及冷冻复苏率显著性相关(P＜0.01)。按照周期妊娠率的高低分组，上述精液常规指标在不同组间均具有显著性差异。2、AnnexinV检测指标、精子凋亡率及DNA碎片指数与供精者的周期妊娠率显著相关，且当AnnexinV检测中膜完整的细胞(PI~-)比例＞48.8％，凋亡率或DFI值＜7％时，周期妊娠率有显著提高。结论：精子膜内侧的磷脂酰丝氨酸(PS)外翻以及精子核DNA的损伤都可以导致供精者生育能力降低，而常规的精液分析无法检测出这些异常，因此供精者生育能力的评价不能仅仅依赖常规检测，还应结合这些指针进行综合分析和预测。
[Abstract]:Nowadays, artificial sperm insemination (AID) has become a routine treatment, which has solved the fertility problem for many infertile couples. The clinical practice of AID has proved that different sperm donors have different ability to conceive women. The difference in pregnancy rate was significant. The important reason for this difference is the individual difference in fertility of the donor. Therefore, it is of great significance to analyze the fertility of the donor. Objective: to explore the effect of frozen semen used for artificial insemination (AID) therapy on fertility of sperm donors, to provide a new index for evaluation of male fertility, and to provide evidence for better screening of sperm donors and improving clinical pregnancy rate of AID. Methods: 1. The data of database management system of our hospital were reviewed. 50 semen samples of spermatozoa from 2001 to 2006 were selected, and the cycle pregnancy rate (cycle pregnancy rate = pregnancy number / cycle number) and semen routine index were counted. The relationship between sperm routine index and cycle pregnancy rate was analyzed by using the rate of cycle pregnancy as the criterion for judging fertility of spermatozoa. Tunel and chromatin structure of sperm were detected by Annexin V-FITC flow cytometry. The relationship between the integrity of sperm membrane and DNA fragments, chromatin structure and pregnancy rate of 50 frozen semen was analyzed. Results there was a significant correlation between the pregnancy rate of cycle and the normal morphology rate of spermatozoa, the rate of viability after freezing, the total number of motile spermatozoa after freezing and the rate of cryopreservation (P < 0.01). According to the pregnancy rate of cycle, the semen routine indexes were significantly different among different groups. The sperm apoptosis rate and DNA fragment index were significantly correlated with the cycle pregnancy rate of sperm donors. Moreover, when the proportion of PI~- was more than 48. 8%, the rate of apoptosis or DFI < 7, the rate of cycle pregnancy was significantly increased by AnnexinV. Conclusion: the procreation of phosphatidyl serine (PS) in the medial sperm membrane and the damage of DNA in the sperm nucleus can decrease the fertility of the sperm donor, but these abnormalities can not be detected by routine semen analysis. Therefore, the evaluation of fertility should not only depend on routine tests, but also be combined with these indicators for comprehensive analysis and prediction.
【学位授予单位】：中南大学
【学位级别】：硕士
【学位授予年份】：2007
【分类号】：R321

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