CAJ | 학술논문

目的：研究精子形态与胚胎发育及临床结局的相关性。方法回顾性分析2012年4月至2013年5月期间来我中心就诊的不孕不育患者，严格按照WHO第五版规定，以单纯输卵管因素的不孕不育患者（n=112）为对照，其中接受体外受精（IVF）助孕的患者100例，胞浆内单精子显微注射（ICSI）患者12例，以男方单一畸形精子症和女方单一输卵管因素的不孕不育患者（n=75）为研究对象，其中接受IVF助孕的患者59例，ICSI患者16例，以植入前胚胎发育参数（正常受精率、卵裂率、优胚率）和临床妊娠结局（临床妊娠率、流产率）为指标，综合评估精子形态对胚胎发育和妊娠结局的影响。结果行IVF助孕后，对照组的胚胎正常受精率、卵裂率、优胚率、临床妊娠率、流产率分别为83.09%、94.52%、49.58%、62%、5.14%，单一畸形精子症患者的胚胎正常受精率、卵裂率、优胚率、临床妊娠率、流产率分别为83.64%、95.26%、41.88%、64.41%、6.95%，各项指标均无显著差异（P＞0.05）；行ICSI助孕后，对照组胚胎正常受精率、卵裂率、优胚率、临床妊娠率分别为86.54%、96.80%、43.08%、56%，单一畸形精子症患者的对应指标分别为87.78%、98.13%、41.67%、56.25%，均无统计学差异（P ＞0.05），但单一畸形精子症患者的流产率却显著升高，差异具有统计学意义（6.19%Vs19.5%，P＜0.05）。结论单一畸形精子症患者行ICSI助孕后胎儿流产风险显著增加。
목적：연구정자형태여배태발육급림상결국적상관성。방법회고성분석2012년4월지2013년5월기간래아중심취진적불잉불육환자，엄격안조WHO제오판규정，이단순수란관인소적불잉불육환자（n=112）위대조，기중접수체외수정（IVF）조잉적환자100례，포장내단정자현미주사（ICSI）환자12례，이남방단일기형정자증화녀방단일수란관인소적불잉불육환자（n=75）위연구대상，기중접수IVF조잉적환자59례，ICSI환자16례，이식입전배태발육삼수（정상수정솔、란렬솔、우배솔）화림상임신결국（림상임신솔、유산솔）위지표，종합평고정자형태대배태발육화임신결국적영향。결과행IVF조잉후，대조조적배태정상수정솔、란렬솔、우배솔、림상임신솔、유산솔분별위83.09%、94.52%、49.58%、62%、5.14%，단일기형정자증환자적배태정상수정솔、란렬솔、우배솔、림상임신솔、유산솔분별위83.64%、95.26%、41.88%、64.41%、6.95%，각항지표균무현저차이（P＞0.05）；행ICSI조잉후，대조조배태정상수정솔、란렬솔、우배솔、림상임신솔분별위86.54%、96.80%、43.08%、56%，단일기형정자증환자적대응지표분별위87.78%、98.13%、41.67%、56.25%，균무통계학차이（P ＞0.05），단단일기형정자증환자적유산솔각현저승고，차이구유통계학의의（6.19%Vs19.5%，P＜0.05）。결론단일기형정자증환자행ICSI조잉후태인유산풍험현저증가。
Objective To determine the relationship between sperm morphology, embryonic development and clinical outcomes. Methods Clinical data of infertility patients in our center were retrospectively analyzed from April 2012 to May 2013. In accordance with criteria (the fifth version of WHO), pure tubal factor infertility patients (n=112) were taken as the control, including 100 couples who underwent IVF and 12 couples for ICSI. The infertility patients (n=75) such as men with isolated teratozoospermia or the women with a single tubal factor were the research object in the study, including 59 couples who underwent IVF and 16 couples for ICSI. The pre-implantation embryo development parameters (including normal fertilization rate, cleavage rate, quality embryos rate) and clinical pregnancy outcomes parameters (clinical pregnancy, spontaneous abortion rate) were indicators to assess the relationship between sperm morphology, embryo development and pregnancy outcomes. Results After IVF, fertilization rate, cleavage rate, excellent embryo rate, clinical pregnancy, miscarriage rates of the control group were 83.09%, 94.52%, 49.58%, 62% and 5.14%. The embryos normal fertilization rate, cleavage rate, quality embryos rate, clinical pregnancy, spontaneous abortion rate of the study group were 83.64%, 95.26%, 41.88%, 64.41% and 6.95%, these indicators mentioned above had not significant differences (P>0.05); After ICSI, embryos normal fertilization rate, cleavage rate, quality embryos rate, clinical pregnancy rates of the control group were 86.54%, 96.80%, 43.08%, 56% and 6.19%, corresponding indicators of the isolated teratozoospermia patients were 87.78%, 98.13%, 41.67%, 56.25%, 19.5%, there were no statistical differences (P> 0.05), but the isolated teratozoospermia patients had significantly higher rate of spontaneous abortion with a significant difference (the control group VS the isolated teratozoospermia patients group, P<0.05). Conclusion Isolated teratozoospermia patients after undergoing ICSI might significantly increase the risk of spontaneous abortion.