Objective: To investigate the association of sperm DNA integrity with semen routine parameters and seminal plasma oxidative stress and its influence on in vitro fertilization (IVF) in males with infertility.
Methods: Using sperm chromatin dispersion (SCD), we detected sperm DNA damage in 433 infertile men undergoing IVF. Based on the sperm DNA fragmentation index (DFI), we divided the patients into a low DFI (lt;30%) and a high DFI ( ≥30%) group and then compared sperm concentration, the percentage of progressively motile sperm (PMS), the contents of malondialdehyde (MDA) and total antioxidant capacity (TAC) in the seminal plasma, and the rates of fertilization, cleavage and high-quality embryos between the two groups of patients.
Results: Compared with the low DFI group, the high DFI group showed significantly decreased rates of PMS (［48.6±16.7］ vs ［29.2±16.8］%, P<0.01) and fast PMS ［19.0±9.1］ vs ［9.4±6.6］%, P<0.01), but no statistically significant difference in sperm concentration (［51.4±30.9］ vs ［52.3±32.4］ ×106/ml, P>0.05). The content of MDA in the seminal plasma was markedly higher in the high DFI than in the low DFI group (［2.28±0.26］ vs ［0.95±0.18］ nmol/L, P<0.01) but that of TAC remarkably lower in the former than in the latter (［10.2±3.5］ vs ［33.2±7.9］ U/L, P<0.01). The rate of fertilization was significantly lower in the high DFI than in the low DFI group (［58.9±30.0］ vs ［77.2±25.0］%, P<0.01), but there were no significant differences between the two groups in the rates of cleavage (［70.7±35.6］ vs ［80.4±15.6］%P>0.05) and high-quality embryos (［40.4±31.3］ vs ［41.7±29.4］%,P>0.05).
Conclusions: Sperm DNA damage is associated with seminal oxidative stress and may affect the outcomes of IVF by reducing the rate of fertilization.
目的： 探讨男性不育患者精子DNA完整性与精液常规参数、精浆氧化应激水平的关系，以及对体外受精(IVF)结局的影响。 方法： 采用精子染色质扩散法（SCD）检测433个IVF周期中精子DNA损伤性，根据精子DNA碎片指数（DFI）的不同，分为低DFI组（DFIlt;30%）、高DFI组（DFI ≥30%），比较2组精子浓度、前向运动精子百分率、快速前向运动精子百分率、精浆丙二醛（MDA）、总抗氧化能力（TAC）水平及受精率、卵裂率、优胚率的差异。 结果： 高DFI组与低DFI组比较，前向运动精子百分率及快速前向运动精子百分率显著降低 ［(29.2±16.8）% vs （48.6±16.7）%、（9.4±6.6）% vs （19.0±9.1）%，P<0.01］，高DFI组精子浓度与低DFI组相比差异无显著性［(52.3±32.4)×10⁶/mlvs (51.4±30.9)×10⁶/ml，P>0.05］；高DFI组精浆中的MDA含量明显高于低DFI组 ［(2.28±0.26) nmol/L vs (0.95±0.18) nmol/L，P<0.01］，高DFI组精浆中的TAC含量明显低于低DFI组［(10.2±3.5) U/L vs (33.2±7.9) U/L，P<0.01］；高DFI组IVF受精率明显低于低DFI组［(58.9±30.0)% vs (77.2±25.0)%，P<0.01］，两组间卵裂率［（70.7±35.6)% vs (80.4±15.6］、优胚率［（40.4±31.3)% vs (41.7±29.4)］比较差异均无显著性（P均>0.05）。 结论： 精子DNA损伤与氧化应激有关，同时精子DNA损伤可降低IVF受精率，影响IVF结局。.
Keywords: in vitro fertilization; malonaldehyde; oxidative stress; sperm DNA integrity; total antioxidant capacity.