新型精子DNA 碎片化檢測與精液參數和試管嬰兒胚胎品質相關

研究目的

評估通過兩種新型SCD（精子染色質分散檢測sperm chromatin dispersion）檢測的精子DNA碎片化與精子參數以及人工生殖結果的關聯。
To evaluate the association between sperm DNA fragmentation measured by two new SCD-based assay and sperm parameters as well as ART outcomes.

研究總結

通過新型精子DNA碎片化檢測測量出的精子DNA碎片化程度與精液參數和胚胎品質有顯著負相關。
Sperm DNA fragmentation assessed by novel sperm DNA fragmentation assay is significantly negative correlated with semen parameters and embryo quality.

已知內容

精子DNA碎片化是精子染色質的其中一個主要缺陷。這可能會導致男性不孕症、異常的胚胎發展和流產。迄今為止，SDF檢測已成為部分醫療機構作為診斷的附加評估，預測生育能力和提供治療方案的指引。試管嬰兒（IVF）和單一精蟲顯微注射（ICSI）等輔助生殖科技（ART）在過去20年中扮演了舉足輕重的角色。然而，部分高度SDF的患者在接受ART療程後仍可能出現較差的臨床結果。
Sperm DNA fragmentation (SDF) is one of the major defects in sperm chromatin. This may lead to male infertility, abnormal embryological development, and pregnancy loss. To date, SDF testing has emerged as a means of diagnosis in some medical institutions as an additional assessment for predicting fecundity and guiding treatment regimen. Assisted reproductive technology (ART) such as IVF and ICSI have played a pivotal role in the treatment of infertility over two decades. However, a parts of patients with high level of SDF underwent ART may still have poor clinical outcome.

研究設計

這個前瞻性世代研究總共有200名參與者。研究數據是從生殖醫學中心的2020年6月至2021年12月資料中取得。
A total of 200 participants was included in this prospective cohort study. Data was collected from the reproductive medicine center from June 2020 through December 2021.

研究方法

這些研究包含了200對進行輔助生殖治療的不孕夫婦。使用LensHooke® R10 (R10)和LensHooke® R11 (R11)檢測套組來針對受精當天收集到的精液樣本進行SDF分析。比較低程度SCF和高程度SCF兩組之間的精液分析參數、胚胎學評分以及ART治療臨床結果。
This study included 200 infertile couples attending for assisted reproductive treatment. Semen sample collected on the day of fertilization was analyzed for SDF by using LensHooke® R10 (R10) and LensHooke® R11 (R11) kits. Semen analysis parameters, embryologic outcome, and clinical outcome after ART treatment were compared between groups with low-level SDF and high-level SDF.

研究結果

由R10檢測出的SDF結果與精子總活動力呈現負相關(Spearman's ρ=-0.24,P=0.0007)。由R11檢測出的SDF結果與精子濃度 (Spearman's ρ=-0.26, P = 0.0002)、總活動力(Spearman's ρ=-0.45, P < 0.0001)、進行性活動力(Spearman's ρ=-0.29, P < 0.0001)以及正常型態 (Spearman's ρ=-0.43, P < 0.0001)呈現負相關。此外，R10檢測出的SDF在弱精症群組 (26.9% ± 19.5%, p < 0.05) 顯著高於正常精子樣本群組(14.8% ± 8.9%)。R11檢測出的SDF在寡精症群組(21.1% ± 17.9%,p<0.01)、弱精症群組(25.3% ± 19.4%, p < 0.001)、畸精症群組 (17% ± 13.2%, p < 0.01)以及寡弱畸精症群組 (35.6% ± 24.5%, p < 0.0001)中顯著高於正常精子樣本群組(7.9% ± 4.2%)。除此之外，通過R11檢測，低度SDF (< 14%) 和高度SDF (≥ 14%)的胚胎良率是有顯著差異。
The SDF assessed by R10 was negatively correlated with sperm total motility (Spearman's ρ=-0.24,P=0.0007). The SDF assessed by R11 was negatively correlated with sperm concentration (Spearman's ρ=-0.26, P = 0.0002), total motility (Spearman's ρ=-0.45, P < 0.0001), progressive motility (Spearman's ρ=-0.29, P < 0.0001), and normal morphology (Spearman's ρ=-0.43, P < 0.0001). Moreover, SDF obtained by the R10 in asthenozoospermic (26.9% ± 19.5%, p < 0.05) was significantly higher than that in normozoospermic samples (14.8% ± 8.9%). SDF obtained by the R11 in oligozoospermic (21.1% ± 17.9%,p<0.01), asthenozoospermic (25.3% ± 19.4%, p < 0.001), teratozoospermic (17% ± 13.2%, p < 0.01), and oligoasthenoteratozoospermic samples (35.6% ± 24.5%, p < 0.0001) were significantly higher than that in normozoospermic samples (7.9% ± 4.2%). In addition, there was significant difference in good embryo rate post IVF between the groups of low SDF (< 14%) and high SDF (≥ 14%), as measured by R11.

研究限制

未來專注於男性因素相關的不孕症，研究沒有納入年齡大於38歲的女性伴侶，但其他女性因素並沒有在此研究中排出。
To focus on male factor-related infertility, the female partner with an age above 38 years old was not enrolled, however, other female factors were not precluded from this study.

研究結果的更廣泛意義

精子DNA碎片化已被證實在男主生育評估中成為一個有價值的生物標誌，而作為ART臨床結果的預測指標則需要更進一步的研究。
Sperm DNA fragmentation has proven to be a valuable biomarker in male fertility evaluation, while its significance as a predictor of clinical outcomes following ART requires further investigation.

原文內容

C.I Lee, M.S Lee, C.C Huang, H.M Tsao, L.S Chang, C.T Hsu, P-029 Sperm DNA fragmentation measured by novel sperm chromatin dispersion-based assay is associated with semen parameter and embryo quality after IVF, Human Reproduction, Volume 37, Issue Supplement_1, July 2022, deac107.027, https://doi.org/10.1093/humrep/deac107.027