| Objective To study the effect of sperm quality on the outcome of in vitro fertilization embryo transfer(IVF-ET),and to explore the predictive value of various sperm quality indicators on the outcome of IVF-ET.Methods This study is a retrospective study,collecting clinical data of 1223 fresh cycles of infertility patients who underwent routine IVF-ET treatment at the assisted reproduction center of Tangshan Maternal and Child Health Hospital from January 2019to June 2020.In the process of embryo culture,the quality of gametes and embryos at each stage was evaluated and recorded through morphological standards,and the pregnancy outcome after embryo transfer was followed up.Use SPSS22.0 software to performX~2 test to analyze the impact of sperm quality indicators on IVF-ET embryo quality and pregnancy outcome,use Medcalc19.0 to draw receiver operating characteristic(ROC)curve,determine the total number of PR,normal morphology rate,AR incidence rate And SDF diagnostic threshold,calculate the area under the curve(AUC),Youden index,sensitivity,and specificity to judge the diagnostic efficacy of each index.Results 1 There was no statistically significant difference in IVF-ET embryo quality and pregnancy outcome between the normal group and abnormal group of PR sperm count and normal morphological rate;2 The 2PN fertilization rate of the AR normal group was significantly higher than that of the abnormal group(P<0.05),as other embryo quality and pregnancy outcome indicators were not statistically different(P>0.05);3 There was no statistical difference in MII egg rate,2PN fertilization rate and transferable embryo rate between the SDF normal group and abnormal group(P>0.05),but the difference in high-quality embryo rate,blastocyst formation rate,high-quality blastocyst rate,and clinical pregnancy rate was statistically significant(P<0.05),and they were all higher in the normal group than in the abnormal group.4 According to the results of ROC curve,the area under the curve(AUC)of total PR,normal morphology rate and AR incidence were 0.524(95%CI:0.496-0.552),0.506(95%CI:0.478-0.534)and 0.512(95%CI:0.483-0.540),respectively.The area under the curve of SDF is 0.696(95%CI:0.669-0.721),P<0.001.The cut-off value of SDF was 29.64%.The sensitivity,specificity and Youden index were 74.20%,57.95%and 0.3215 respectively.Conclusion 1 In the conventional IVF cycles,the pros and cons of parameters such as semen volume,concentration,vitality,and normal morphological rate obtained by semen analysis do not cause significant differences in embryo quality and pregnancy outcome,and have no predictive value;2 Sperm acrosome reaction rate will affect the normal fertilization rate after conventional fertilization,but does not affect the subsequent embryonic development and pregnancy outcome,so it can be used as an auxiliary indicator to guide the treatment cycle,but the evidence as an indicator to predict pregnancy outcome is insufficient;3 The level of SDF can significantly affect embryonic development and subsequent clinical pregnancy outcome,and it may be a good predictor of clinical pregnancy.This parameter can be used as a guide for men’s medication and prognosis evaluation before the in vitro fertilization cycle.Figure 9;Table 8;Reference 86... |
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