生殖医学杂志2025，Vol.34Issue(9)：1176-1182,7.DOI:10.3969/j.issn.1004-3845.2025.09.004
不同精液优化处理方法对体外受精-胚胎移植临床结局的影响
The effect of different methods of sperm optimization on the clinical outcomes of in vitro fertilization and embryo transfer
摘要
Abstract
Objective:To investigate the effects of dual-density gradient centrifugation combined with swim-up method and flotation method on the clinical outcomes of in vitro fertilization-embryo transfer(IVF-ET). Methods:A retrospective analysis was conducted on the clinical data of 2 015 cycles(total 1 977 couples)who underwent routine IVF assisted pregnancy using antagonist regimen during ovulation induction in Sichuan Jinxin Xinan Women & Children's Hospital from August 1,2023 to July 31,2024 were retrospectively analyzed.According to different semen treatment methods,they were divided into gradient swim-up group(n=1 476 cycles,1 447 couples in total)and the flotation group(n=539 cycles,530 couples in total).There were 599 cycles in the fresh transplantation(596 couples in total),which were divided into the gradient swim-up group(n=433 cycles,431 couples in total)and the flotation group(n=166 cycles,165 couples in total).A comparative analysis was conducted on the basic characteristics,fertilization,embryo development and pregnancy outcomes of fresh transplantation cycles between the two groups.In addition,semen samples from 22 husbands of couples who underwent routine IVF treatment from August 1,2024 to September 15,2024 were selected and optimized by two semen treatment methods,respectively.The sperm DNA fragmentation index(DFI)was detected by sperm chromatin dispersion(SCD)method.The difference of sperm DFI after two methods of semen optimization was compared. Results:In the comparison of basic characteristics,except for the significant difference in the dosage of Gn,there were no significant differences in other basic data(P＞0.05).In the comparison of fertilization and embryo development,except for the significantly lower multiple pronucleus(PN)rate(multi-PN rate)of the flotation group compared with the gradient swim-up group(P＜0.01),there were no significant differences in 2PN rate,D3 high-quality embryo rate,high-quality blastocyst rate,blastocyst development rate,frozen blastocyst rate between the two groups(P＞0.05).In the comparison of pregnancy outcomes in the fresh transplantation cycles,the embryo implantation rate(34.94％vs.43.38％),the clinical pregnancy rate of D3 cleavage embryos(48.74％vs.60.74％)and the clinical pregnancy rate of total transplanted embryos(48.80％vs.60.05％)in the flotation group were significantly lower than those in the gradient swim-up group(P＜0.05).In the comparison of DFI,both of the two sperm optimization processing methods could screen out sperm with low DFI,and the sperm DFI screened out by the gradient swim-up group was significantly lower than that of the flotation group[0.62(0.40,1.39)％vs.2.02(1.32,6.46)％,P＜0.05]. Conclusions:Sperm with lower multi-PN rate in IVF-ET can be screened by flotation method,while sperm with lower DFI can be obtained by dual-density gradient centrifugation combined with swim-up method,resulting in better pregnancy outcome in fresh transplant cycle.关键词
双层密度梯度/浮游法/DNA碎片指数/胚胎着床率Key words
Dual-density gradient/Flotation method/DNA fragmentation index/Embryo implantation rate分类
医药卫生引用本文复制引用
张阳波,韩婷婷,徐敬良,王琪,严维,黄军,孟祥黔..不同精液优化处理方法对体外受精-胚胎移植临床结局的影响[J].生殖医学杂志,2025,34(9):1176-1182,7.基金项目
四川省医学会课题(S21098) （S21098）
成都市卫生健康委员会课题(202301033807) （202301033807）
