■男性精子DNA断裂(SDF)可能与辅助生殖技术(ART)结果有关,但SDF对非整倍体相关流产发生的影响仍存在争议.
■对郑州大学第一附属医院生殖医学中心进行IVF/ICSI治疗的495个流产绒毛绒毛样本进行了基于全基因组单核苷酸多态性的染色体微阵列分析。使用精子染色质结构测定评估SDF。根据胚胎移植周期类型和母亲年龄将患者分为四组,并分析了SDF与染色体畸变的相关性。利用受试者工作特性(ROC)曲线来寻找最佳阈值。
■总染色体非整倍体率为54.95%,三体性是最常见的异常(71.32%)。染色体异常组的SDF高于正常组(11.42%[6.82%,16.54%]vs.12.95%[9.61%,20.58%],P=0.032)。分组后,仅在接受新鲜胚胎移植的高龄女性中,SDF升高与染色体非整倍体率显着相关(调整后的比值比:1.14[1.00-1.29],调整后P=0.045)。受试者工作特征曲线表明,SDF可以预测该组中流产概念染色体异常的发生((曲线下面积=0.76[0.60-0.91],P=0.005),最佳阈值为8.5%。当SDF≥8.5%时,此类患者的风险增加了5.76倍(调整后的优势比:6.76[1.20-37.99],调整后P=0.030)。
■对于接受新鲜胚胎移植的高龄产妇,在IVF/ICSI治疗中使用高SDF精子受精的老年卵母细胞可能会增加流产概念中染色体异常的风险。
UNASSIGNED: Male sperm DNA fragmentation (SDF) may be associated with assisted reproductive technology (ART) outcomes, but the impact of SDF on the occurrence of aneuploid-related miscarriage remains controversial.
UNASSIGNED: Genome-wide single-nucleotide polymorphism-based chromosomal microarray analysis was performed on 495 miscarried chorionic villus samples undergone IVF/ICSI treatment from the Reproductive Medicine Center of the First Affiliated Hospital of Zhengzhou University. SDF was assessed using sperm chromatin structure assay. Patients were divided into four groups according to embryo transfer cycle type and maternal age, and the correlation between SDF and chromosome aberration was analyzed. A receiver operating characteristic (ROC) curve was utilized to find the optimal threshold.
UNASSIGNED: Total chromosomal aneuploidy rate was 54.95%, and trisomy was the most common abnormality (71.32%). The chromosomally abnormal group had higher SDF than the normal group (11.42% [6.82%, 16.54%] vs. 12.95% [9.61%, 20.58%], P = 0.032). After grouping, elevated SDF was significantly correlated with an increasing chromosome aneuploidy rate only in women of advanced age who underwent fresh embryo transfer (adjusted odds ratio:1.14 [1.00-1.29], adjusted-P = 0.045). The receiver operating characteristic curve showed that SDF can predict the occurrence of chromosomal abnormality of miscarried conceptus in this group ((area under the curve = 0.76 [0.60-0.91], P = 0.005), and 8.5% was the optimum threshold. When SDF was ≥ 8.5%, the risk of such patients increased by 5.76 times (adjusted odds ratio: 6.76 [1.20-37.99], adjusted-P = 0.030).
UNASSIGNED: For women of advanced maternal age undergoing fresh embryo transfer, older oocytes fertilized using sperm with high SDF in IVF/ICSI treatment might increase the risk of chromosomal abnormality in miscarried conceptus.