| ObjectiveStudies have shown that there is a certain correlation between DFI and male infertility and spontaneous abortion.With the advancement of assisted reproductive technology,people have begun to pay attention to the impact of DFI on IUI and IVF.The results of many previous studies on " the relationship between sperm DFI and IUI、 IVF " are quite different.In addition,most of the DFI values used in the study came from men’s routine examination,and embryo transfer mostly focused on fresh embryo transfer.In order to further explore the changes of DFI before and after semen processing and its impact on in vitro fertilization embryo trans plantation,we will carry out the following aspects:1.To explore the changes of each data（PR+NP、PR、NP、IM、DFI、HDS）before and after semen processing,and the influence of smoking,drinking,regular exercise,and long-term exposure to radiation on each data.2.To analyze the relationship between DFI and semen datas（age、BMI、abstinence duration、infertility duration、semen volume、perm concentration、PR+NP、PR、NP、IM、HDS）.3.To study the differences in datas（age、BMI、sperm concentration、PR+NP、PR、NP、IM、HDS）in different DFI intervals.4.To explore the effect of DFI on in vitro fertilization embryo trans plantation and the threshold of DFI.Methods1.Select couples who will go to the Assisted Reproductive Center of the Sixth Medical Center of the PLA General Hospital from May 2021 to November 2021,who plan to undergo IVF assisted pregnancy and meet the inclusion criteria.All couples need to fill out a questionnaire,and then collect data on the couple’s age,BMI and the man’s living habits.2.On the day of in IVF,male semen samples were optimized（density gradient method and upstream method）.After that,the remaining semen samples were examined by semen routine（semen volume、sperm concentration、PR+NP、PR、NP、IM）and sperm DFI.3.The changes of parameters（PR+NP、PR、NP、IM、DFI、HDS）were compared before and after treatment.Smoking,drinking,regular exercise and long-term exposure to radiation were grouped as influencing factors,and the effects of four influencing factors on the above parameters were compared.4.According to the DFI of spermatozoa before treatment,they were divided into 3 groups（group A,DFI≤15%;group B,15%0.05）.On the other hand,only " long-term radiation " had a statistically significant effect on the parameter of HDS after treatment（Z =-2.194,P<0.05）.4.Whether it is not processed or processed,DFI shows no relationship with age,BMI,infertility duration,abstinence duration,semen volume,HDS（P>0.05）,but when it with PR+NP and PR is analyzed,result showed negative correlation,on the contrary,the opposite is related with IM（P<0.05）.For NP,there was a negative correlation before treatment（r =-0.219,P = 0.037）but no correlation after treatment（P>0.05）.5.BMI,sperm concentration,NP and HDS of men in group A,B and C showed no significant differences（P > 0.05）.The age of patients in group C was significantly higher than that in group A and B（compared with group A: t =-2.612,P = 0.012;Compared with group B,Z =-2.046,P = 0.046）,while there was no significant difference in age between group A and B（t =-0.893,P = 0.375）.The PR+NP of group A,B and C showed A significant decreasing trend（group A and group B: Z =-2.470,P = 0.014;group A and group C: Z =-3.593,P = 0.000;group B and group C: t = 3.681,P = 0.001）.PR also showed significant downward trend,while there was no significant difference between group A and group B（t = 1.714,P = 0.090）.IM showed a significant increase trend（group A and group B: Z =-2.470,P = 0.014;group A and group C: Z =-3.593,P = 0.000;group B and group C: t =-3.681,P = 0.001）.6.There was no difference in 2PN fertilization rate between group A（DFI≤15%）and group B（15% 0.05）.7.When the DFI was > 27.99% before treatment,95%CI was 0.487-1.000,and the sensitivity and specificity of predicting 2PN fertilization rate < 30% was 67% and 92%.When the DFI of treated sperm was > 7.88%,the 95%CI was 0.577-0.956,and the sensitivity and specificity of predicting 2PN fertilization rate < 30% was 67% and 76%.8.No biochemical pregnancy occurred in groups Ⅰ,Ⅱ,Ⅲ and Ⅳ.Clinical pregnancy rates did not differ by embryo type and DFI（χ2 = 0.514,P = 0.916）.Conclusion1.Semen optimization（density gradient centrifugation combined with swim-up）can significantly improve the quality of semen.No matter before or after treatment,when DFI increased,PR+NP and PR showed a decrease,and IM showed an upward trend.2.2PN fertilization rate started to fall when pre-treatment DFI exceeded 30%.3.When 2PN fertilization rate < 30% was positive,the threshold of DFI before treatment was 27.99%,and the threshold of DFI after treatment was 7.88%.4.When pre-treatment DFI does not exceed 30%,clinical pregnancy rates did not show differences due to the different types of embryos and the DFI. |
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