| Objective:The correlation of sperm DNA fragmentation index(DFI)and sperm nucleoprotein transformation(SNT)with age and semen routine parameters on the day of oocyte retrieval were explored.The changes of sperm DFI and SNT after density gradient centrifugation(DGC)and their effects on in vitro fertilization and embryo transfer(IVF-ET)were analyzed.Methods:1.359 infertile couples who received IVF due to fallopian tube factor in the reproductive medicine department of the second hospital of Hebei Medical University from May 2020 to December 2020 were selected and the semen before and after DGC on the day of oocyte retrieval were performed on semen routine test,sperm morphology detection,sperm chromatin structure analysis(SCSA)and SNT detection.2.According to whether the semen routine test was normal or not,the sperm was divided into normal sperm group and abnormal sperm group.Sperm DFI and SNT were compared between<35-year-old group and≥35-year-old group.3.The different levels of sperm motility,normal morphological rate,sperm DFI and SNT between optimized sperm group and protoplasmic sperm group were compared.4.According to the level of sperm DFI before DGC,the patients were divided into group A:DFI≤15%,group B:15%<DFI<30%and group C:DFI≥30%.According to the level of SNT before DGC,the patients were divided into group D:SNT≤15%,group E:15%<SNT<30%and group F:SNT≥30%.The general conditions,clinical indicators,laboratory indicators and clinical outcomes of the three groups were compared.Results:1.Sperm DFI was positively correlated with male age(r_s=0.137,P<0.001)and percentage of abnormal head(r_s=0.377,P<0.001).On the contrary,it was negatively correlated with sperm progressive movement rate(PR)(r_s=-0.133,P<0.05)and percentage of normal sperm(r_s=-0.214,P<0.05).SNT was positively correlated with male age(r_s=0.439,P<0.001)and percentage of abnormal head(r_s=0.203,P<0.001).On the contrary,it was negatively correlated with PR(r_s=-0.110,P<0.05)and percentage of normal sperm(r_s=-0.113,P<0.05).There were no significant correlation between sperm DFI and sperm concentration,motility,abnormal percentage of neck and tail(P>0.05),so were SNT(P>0.05).There was a significant positive correlation between sperm DFI and SNT(r_s=0.601,P<0.001).2.In normal sperm group,sperm DFI and SNT of≥35 years old group were significantly higher than those of<35 years old group(P<0.001).Taking30%as the cut-off value,the abnormal rate of sperm DFI of≥35 years old group(28.89%)was higher than that of<35 years old group(7.41%).The abnormal rate of SNT of≥35 years old group(40%)was higher than that of<35 years old group(4.17%),and the difference was also statistically significant(P<0.001).In abnormal sperm group,there was no significant difference in sperm DFI and SNT between the≥35 years old group and the<35 years old group(P>0.05).3.Compared with protoplasmic semen,sperm motility and percentage of normal sperm morphology were increased,but sperm DFI and SNT were decreased after DGC.The number of optimized sperm DFI decreased of≥35years old group was higher than that of<35 years old group(P<0.05).4.There were no significant differences in general conditions and clinical indicators among the three groups(P>0.05).The fertilization rate of group B and C was lower than that of group A and there was a significant difference(P<0.05).Although 2PN fertilization rate of group B and C was lower than that of group A,there was no statistical difference(P>0.05).There were no difference in implantation rate and clinical pregnancy rate of fresh embryo transfer among the three groups(P>0.05).The rate of early abortion in group C was higher than that in group A and group B,but there was no significant difference(P>0.05).The pregnancy rate of the first frozen-thawed embryo transfer(FET)of group C after total embryo freezing was lower than that of group A and group B,but there was no statistical difference(P>0.05).5.Female age and male age of group E and F were higher than those of group A and there was a significant difference(P<0.05).There were no significant differences in other general conditions among the three groups(P>0.05).There were no significant differences in clinical indicators among the three groups(P>0.05).The fertilization rate of group F was lower than that of group D and group E.There were no significant differences in implantation rate,clinical pregnancy rate and early abortion rate of fresh embryo transfer(P>0.05).There were also no significant differences in implantation rate and clinical pregnancy rate of the first FET after total embryo freezing(P>0.05).Conclusions:1.Sperm DFI and SNT are positively correlated with male age and abnormal percentage of the sperm head.They are negatively correlated with sperm PR and normal percentage of the sperm.There is a positive correlation between the two parameters.2.DGC can reduce the level of sperm DFI and SNT,but there are exceptions.Age may be one of the factors that influence the improvement of DGC.3.If sperm DFI or SNT≥30%,IVF fertilization rate can be reduced.They have a certain guiding significance for the selection of fertilization methods in infertile patients,but they don’t affect embryo quality and clinical pregnancy.With the increase of sperm DFI level,the early abortion rate tends to increase. |
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