精蟲品質不佳之胚胎XY染色體異常機率明顯較高

精蟲品質不佳之病患施行試管嬰兒治療後胚胎XY染色體異常機率明顯高於一般精蟲品質正常之試管嬰兒病患

Fertil Steril. 2015 Oct;104(4):866-72. doi: 10.1016/j.fertnstert.2015.06.033. Epub 2015 Jul 14.

Use of suboptimal sperm increases the risk of aneuploidy of the sex chromosomes in preimplantation blastocyst embryos.

Coates A1, Hesla JS2, Hurliman A2, Coate B2, Holmes E2, Matthews R2, Mounts EL2, Turner KJ3, Thornhill AR4, Griffin DK5.

Author information

Abstract

OBJECTIVE:

To compare autosomal and sex chromosome aneuploidy rates of embryos derived from sperm with abnormal and normal parameters.

DESIGN:

Retrospective cohort study.

SETTING:

Assisted reproduction center.

PATIENT(S):

Three thousand eight hundred thirty-five embryos generated from 629 couples undergoing IVF.

INTERVENTION(S):

None.

MAIN OUTCOME MEASURE(S):

Incidence of aneuploidy in the trophectoderm of blastocyst embryos derived from standard IVF embryos and intracytoplasmic (ICSI) males with normal and oligozoospermic semen samples, in couples with donor eggs (mean maternal age, 25.0 years) and their own eggs (mean maternal age, 35.4 years).

RESULT(S):

The rate of sex chromosome aneuploidy was significantly (around threefold) higher in the oligozoospermic group compared with in both control groups (standard vs. ICSI insemination). This applied whether donor (young) or own (older) eggs were used. Significant differences were seen in the oligozoospermic samples for autosomes 1, 2, 11 (own eggs), and 18 (donor eggs) compared with both control groups; however, no significant difference was seen between each of the treatment groups for the overall rate of autosomal aneuploidy. No significant differences were seen between the two control groups (normozoospermic males, standard vs. ICSI insemination) in either of the egg group types for any chromosome pairs.

CONCLUSION(S):

Severe male factor infertility is associated with a significant increase in the occurrence of sex chromosome abnormalities in blastocyst embryos compared with in embryos derived from normal semen samples. Aneuploidy rates in embryos derived from sperm with normal parameters were not significantly different whether ICSI or standard insemination was used to achieve fertilization. These results highlight severe male factor infertility as a possible referral category for preimplantation comprehensive chromosomal screening.

Copyright © 2015 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.