Journal of Developmental Medicine(Electronic Version)  2022, Vol. 10 Issue (2): 81-88 DOI: DOI：10.3969/j.issn.2095-5340.2022.02.001 |
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| Predictive analysis of combined detection of sperm DNA fragmentation index and mitochondrial membrane potential during ovulation induction on assisted reproductive technology pregnancy outcomes |
| Ye Hong, Yang Xu, Hu Yuanbo,et al
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1. Center of Reproductive Medicine, the First Affiliated Hospital of Naval Medical University, Shanghai
200433, China; 2. National Health Commission Key Laboratory of Family Planning Medicines, Shanghai
Institute for Biomedical and Pharmaceutical Technologies, Shanghai 200032, China
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Abstract 【Abstract】 Objective To explore the predictive effect of sperm DNA fragmentation index (DFI)
and mitochondrial membrane potential (MMP) combined detection on assisted reproductive technology
(ART) pregnancy outcomes during ovulation induction. Method A total of 116 in vitro fertilization/
intracytoplasmic sperm injection cycles which men underwent sperm DFI and/or MMP detection during
ovulation induction were enrolled at the Reproductive Center of the First Affiliated Hospital of Naval Medical University between April 2020 and May 2021. The last testing times were scheduled on the start day of ovulation induction, night needle day or egg retrieval day. Fluorescence was detected by flow cytometry to calculate sperm DFI and MMP value. Patients with DFI ≤15%, 15%~30% and ≥30% were normal value group, critical value group and abnormal value group, respectively. MMP value was detected in all cases with normal DFI value and critical value. Patients with MMP values <30% were abnormal MMP value group. The high-quality embryo rate, embryo implantation rate and mid-to-late pregnancy rate were compared among the groups. Nonparametric test, t-test, variance analysis, χ2 test and binary Logistic regression analysis were used for statistical analysis. Result There was no significant difference in the age of the man, the age of the woman and the years of infertility among the three groups of DFI normal value group, critical value group and abnormal value group (P>0.05). DFI normal value group, critical value group and abnormal value group had 44, 33 and 39 retrieval cycles, respectively. There were statistically significant differences in the high-quality embryo rate [54.4% (198/364), 56.5% (130/230) and 39.5% (83/210), χ2=15.550, P<0.01], embryo implantation rate[48.9% (44/90), 42.4% (25/59) and 25.0% (15/60), χ2=8.709, P<0.05] and mid-to-late pregnancy rate [70.6% (36/51), 44.4% (16/36) and 30.6% (11/36), χ2=14.471, P<0.01] among the three groups. Further pairwise comparisons showed that the high-quality embryo rate, embryo implantation rate and mid-to-late pregnancy rate in the normal DFI value group were higher than those in the abnormal DFI value group; the mid-to-late pregnancy rate in the normal DFI value group was higher than that in the critical DFI value group; the high-quality embryo rate and embryo implantation rate in the critical DFI value group were higher than those in the abnormal DFI value group. The oocyte retrieval cycles of the abnormal MMP value group and the normal value group were 26 and 51, respectively. The high-quality embryo rate [46.0% (57/124) vs 57.7% (271/470), χ2=5.424, P<0.05], embryo implantation rate [18.2% (8/44) vs 58.1% (61/105), χ2=19.867, P<0.01], and mid-to-late pregnancy rate [24.0% (6/25) vs 74.2% (46/62), χ2=18.667, P<0.01] of the abnormal MMP group were lower than those of the normal group. After adjusting for confounding factors by multivariate Logistic regression analysis, the results showed that the DFI value (OR=0.892, 95% CI: 0.801-
0.995, P<0.05) and the MMP value (OR=1.068, 95% CI: 1.009-1.132, P<0.01) were independent factors
affecting the mid-to-late pregnancy rate. The higher the DFI value, the lower the mid-to-late pregnancy rate; the lower the MMP value, the lower the mid-to-late pregnancy rate. Conclusion The DFI value of sperm detected during the ovulation induction period of the woman's ovulation has a significant correlation with the rate of high-quality embryo rate, embryo implantation rate and mid-to-late pregnancy rate. Abnormal MMP in the normal and critical DFI patients significantly reduces the embryo implantation rate and mid-to-late pregnancy. The combined detection of DFI and MMP can predict the outcomes of ART pregnancy.
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Received: 27 December 2021
Published: 31 March 2022
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