【摘要】： 現(xiàn)今，供精人工授精(AID)已成為一種常規(guī)的治療方法，為許多不孕不育的夫婦解決了生育問題。AID的臨床實(shí)踐證明，不同的供精者精液使婦女受孕的能力各異，表現(xiàn)為周期妊娠率差異顯著。導(dǎo)致這一差別的重要原因是供精者生育能力的個(gè)體差異，因此，分析供精者的生育能力具有重要的意義。 目的：探討用于供精人工授精(AID)治療的冷凍精液對(duì)供精者生育能力的影響，為男性生育能力的評(píng)價(jià)提供新的指標(biāo)，，也為更好的篩查供精者和提高AID的臨床妊娠率提供依據(jù)。 方法：1、回顧我院數(shù)據(jù)庫管理系統(tǒng)資料，以2001年至2006年為年限，選取50例用于AID的供精者精液標(biāo)本，統(tǒng)計(jì)其周期妊娠率(周期妊娠率=妊娠個(gè)數(shù)／周期數(shù))及精液常規(guī)指標(biāo)，以周期妊娠率作為供精者生育能力的判斷標(biāo)準(zhǔn)，分析精液常規(guī)指標(biāo)與周期妊娠率的關(guān)系。2、利用Annexin V—FITC流式檢測(cè)、TUNEL檢測(cè)、精子染色質(zhì)結(jié)構(gòu)分析等方法，分析50份冷凍精液精子膜的完整性、DNA碎片值以及染色質(zhì)結(jié)構(gòu)與周期妊娠率的關(guān)系。 結(jié)果：1、周期妊娠率與精子的正常形態(tài)率、凍后活率、凍后前向運(yùn)動(dòng)精子總數(shù)及冷凍復(fù)蘇率顯著性相關(guān)(P＜0.01)。按照周期妊娠率的高低分組，上述精液常規(guī)指標(biāo)在不同組間均具有顯著性差異。2、AnnexinV檢測(cè)指標(biāo)、精子凋亡率及DNA碎片指數(shù)與供精者的周期妊娠率顯著相關(guān)，且當(dāng)AnnexinV檢測(cè)中膜完整的細(xì)胞(PI~-)比例＞48.8％，凋亡率或DFI值＜7％時(shí)，周期妊娠率有顯著提高。 結(jié)論：精子膜內(nèi)側(cè)的磷脂酰絲氨酸(PS)外翻以及精子核DNA的損傷都可以導(dǎo)致供精者生育能力降低，而常規(guī)的精液分析無法檢測(cè)出這些異常，因此供精者生育能力的評(píng)價(jià)不能僅僅依賴常規(guī)檢測(cè)，還應(yīng)結(jié)合這些指針進(jìn)行綜合分析和預(yù)測(cè)。
[Abstract]:Nowadays, artificial sperm insemination (AID) has become a routine treatment, which has solved the fertility problem for many infertile couples. The clinical practice of AID has proved that different sperm donors have different ability to conceive women. The difference in pregnancy rate was significant. The important reason for this difference is the individual difference in fertility of the donor. Therefore, it is of great significance to analyze the fertility of the donor. Objective: to explore the effect of frozen semen used for artificial insemination (AID) therapy on fertility of sperm donors, to provide a new index for evaluation of male fertility, and to provide evidence for better screening of sperm donors and improving clinical pregnancy rate of AID. Methods: 1. The data of database management system of our hospital were reviewed. 50 semen samples of spermatozoa from 2001 to 2006 were selected, and the cycle pregnancy rate (cycle pregnancy rate = pregnancy number / cycle number) and semen routine index were counted. The relationship between sperm routine index and cycle pregnancy rate was analyzed by using the rate of cycle pregnancy as the criterion for judging fertility of spermatozoa. Tunel and chromatin structure of sperm were detected by Annexin V-FITC flow cytometry. The relationship between the integrity of sperm membrane and DNA fragments, chromatin structure and pregnancy rate of 50 frozen semen was analyzed. Results there was a significant correlation between the pregnancy rate of cycle and the normal morphology rate of spermatozoa, the rate of viability after freezing, the total number of motile spermatozoa after freezing and the rate of cryopreservation (P < 0.01). According to the pregnancy rate of cycle, the semen routine indexes were significantly different among different groups. The sperm apoptosis rate and DNA fragment index were significantly correlated with the cycle pregnancy rate of sperm donors. Moreover, when the proportion of PI~- was more than 48. 8%, the rate of apoptosis or DFI < 7, the rate of cycle pregnancy was significantly increased by AnnexinV. Conclusion: the procreation of phosphatidyl serine (PS) in the medial sperm membrane and the damage of DNA in the sperm nucleus can decrease the fertility of the sperm donor, but these abnormalities can not be detected by routine semen analysis. Therefore, the evaluation of fertility should not only depend on routine tests, but also be combined with these indicators for comprehensive analysis and prediction.
【學(xué)位授予單位】：中南大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2007
【分類號(hào)】：R321

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