| Objective: Human Assisted Reproductive Technology (ART) coming outhas a great progress in the treat of infertility and the reproductive success ofpatients with abnormal sperm morphology has a substantial increase byintracytoplasmic sperm injection (ICSI)．ICSI is a single sperm into the oocytecytoplasm by using the method of microinjection, which will make thecombination of sperm and oocyte passive fertilization,to form a fertilizedzygote and transplant. Whether caused by a male factor infertility patients ornot need treatment by ICSI, which depends on the result of semen analysis.However, the analysis results of semen only show sperm morphology,density, activity and activity. These can not reflect the fertilization ability ofsperm completely, just suggest the basic sperm quality. The spermmorphology classification putforward by Macleod draw attention gradually onmale infertile evaluationin the past few years. This study by evaluating theeffect of different morphology sperm rate on the outcomes of intracytoplasmicsperm injection assist the prediction of reproductive outcome and somereference.Methods: The information of cycles undergoing ICSI by male factors inthe ART Department of the Second Hospital of Hebei Medical Universityfrom March2012to February2013was retrospectively analyzed.They weredivided into three groups according to the rate of normal morphology spermrate: group A (normal morphology sperm rate>4%), group B (normalmorphology sperm rate≤4%), group C (normal morphology sperm rate=0). Itwas eventually a total of815cycles of group A,330cycles of group B, a totalof115cycles of group C.①C ompare thefollowing content among the threegroups of the male age, the female age, duration of infertility;②Compare thefollowing content among the three groups of fertilization, cleavage, good quality embryos, embryo implantation, clinical pregnancy, ectopic pregnancy,miscarriage, multiple pregnancy;③Comparethe following content ofejaculated sperm group and surgical sperm extraction group divided fromgroup C: fertilization, cleavage, good quality embryos, embryo implantation,clinical pregnancy,ectopic pregnancy, miscarriage, multiple pregnancy.Results:Normal sperm morphology group (A), not severely deformed spermgroup (B) and severely deformed sperm group (C).1.The results of the comparison are as follows:①The male age in the three groups were29.73±3.13years,30.19±3.85years,31.66±3.10years respectively. There was no significant differenceamong the three groups (F=0.260，P>0.05);②The female age in the threegroups were29.40±3.37years,30.48±3.30years,31.15±2.56yearsrespectively. There was no significant difference among the threegroups(F=0.242，P>0.05);③The duration of infertility in the three groupswere5.33±3.51years,4.85±3.07years,5.17±3.25years respectively. Therewas no significant difference among the three groups (F=0.016，P>0.05),table1;2. Compare the content among the three groups of fertilization(%),cleavage(%), good quality embryos(%), embryo implantation(%), clinicalpregnancy(%), ectopic pregnancy(%), miscarriage(%), multiplepregnancy(%).①T he fertilization rate in groupA, B and C were78.3%(6906/8820),80.1%(2762/3450) and64.5%(840/1302) respectively.There was significant difference among the three groups (P<0.05).Comparedgroup A and group B, there was no significant difference among the twogroups (P>0.01). Compared group A and group C, there was significantdifference among the two groups (χ2=119.983，P<0.001). Compared group Band group C, there was significant difference among the two groups(χ2=124.472，P<0.001);②T he cleavage rate in group A, B and C were89.3%(6167/6906),87.8%(2425/2762) and85.5%(718/840) respectively. There was no significant difference among the three groups (P>0.05);③Thegood quality embryos rate in group A, B and C were60.9%(3756/6167),58.8%(1426/2425) and58.6%(418/714) respectively. There was nosignificant difference among the three groups(P>0.05);④The embryoimplantation rate in group A, B and C were25.2%(386/1532),27.6%(213/771) and23.3%(56/241) respectively.There was no significantdifference among the three groups(P>0.05);⑤The clinical pregnancy rate ingroup A, B and C were48.5%(395/815),47.0%(155/330) and33.0%(38/115)respectively.There was significant difference among the three groups (P<0.05).Compared group A and group B, there was no significant difference among thetwo groups(P>0.01). Compared group A and group C, there was significantdifference among the two groups (χ2=9.634，P=0.002). Compared group B andgroup C, there was significant difference among the two groups (χ2=6.734，P=0.009);⑥T he ectopic pregnancy rate in group A,B and C were3.5%(14/395),5.2%(8/155) and7.9%(3/38) respectively. There was nosignificant difference among the three groups (P>0.05);⑦The miscarriagerate in group A, B and C were3.8%(15/395),5.2%(8/155) and10.5%(4/38)respectively. There was no significant difference among the three groups(P>0.05);⑧T he multiple pregnancy rate in group A, B and C were20.8%(82/395),18.1%(28/155) and23.7%(9/38) respectively. There was nosignificant difference among the three groups(P>0.05);3. In severely deformed sperm group, the comparison between ejaculatedsperm grou（pC1）and surgical sperm extraction group（C2）in fertilization(%),cleavage(%), good quality embryos(%), embryo implantation(%), clinicalpregnancy(%), ectopic pregnancy(%), miscarriage(%), multiplepregnancy(%).①T he fertility rate in groupC1and group C2is65.7%(531/808) and62.6%(309/494) respectively. The comparison between the two groups, thereis no statistically significant difference (P>0.05);②The cleavage rate in groupC1and group C2is88.2%(468/531) and80.9%(250/309). The comparisonbetween the two groups, there is statistically significant difference (χ2=8.224， P=0.004);③The good quality embryos rate in groupC1and group C2is62.6%(293/468) and50.0%(125/250). The comparison between the two groups,there is statistically significant difference (χ2=10.647， P=0.001);④Theembryo implantation rate in group C1and group C2is25.5%(38/149) and19.6%(18/92). The comparison between the two groups, there is nostatistically significant difference (P>0.05);⑤The clinical pregnancy rate ingroup C1and group C2is37.8%(28/74) and24.4%(10/41). The comparisonbetween the two groups, there is no statistically significant difference(P>0.05);⑥T he ectopic pregnancy rate in groupC1and group C2is7.1%(2/28) and10.0%(1/10). The comparison between the two groups, there is nostatistically significant difference (P>0.05);⑦The miscarriage rate in groupC1and group C2is7.1%(2/28) and20.0%(2/10). The comparison betweenthe two groups, there is no statistically significant difference (P>0.05);⑧Themultiple pregnancy rate in group C1and group C2is25.0%(7/28) and20.0%(2/10). The comparison between the two groups, there is no statisticallysignificant difference (P>0.05);Conclusions:Sperm-oocyte binding and the growth of fertilized zygote and embryosare same with normal sperm morphology rate, only if the sperm is normalsperm morphology, when the ICSI technology assists pregnancy. Patients whouse abnormal sperm morphology in ICSI to assists pregnancy, the fertilizationrate and clinical pregnancy rates are lower than who use normal spermmorphology. In very severely deformed sperm group, the cleavage rate andgood quality embryos rate of surgical sperm extraction group are lower thanejaculated sperm group;... |
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