Pre-implantation genetic screening in intracytoplasmic sperm injection for infertile patients with high sperm DNA fragmentation index

YANG Si-jie; LI Ting; LIU Wen; LI Shi-jun; XIE Nan; ZHANG Chen; GAO Xuan; LIU Xiao-dan

doi:10.13263/j.cnki.nja.2018.01.007

Abstract：Objective:To investigate the application value of pre-implantation genetic screening (PGS) in intracytoplasmic sperm injection (ICSI) and embryo transfer (ET) for infertile patients with high sperm DNA fragmentation index (DFI).Methods:We selected 90 infertile patients undergoing ICSI-ET in our center from April 2015 to October 2016,60 with sperm DFI ≥ 15％ and 30 with sperm DFI ＜ 15％.Of the 60 cases with sperm DFI ≥ 15％,30 received PGS-ICSI (high DFI-PGS group) while the other 30 did not receive PGS (high DFI-ICSI group).The 30 cases with sperm DFI ＜ 15％ were included in the low DFI-ICSI group.We made comparisons between the high and low DFI-ICSI groups in the rates of normal fertilization,good-quality embryos,blastocyst formation and embryo implantation as well as between the high DFI-PGS and high DFI-ICSI groups in the ages of the males and females,the levels of follicle-stimulating hormone (FSH),luteinizing hormone (LH) and testosterone (T) in the males,sperm concentration,the percentages of progressively motile sperm (PMS) and morphologically normal sperm (MNS),sperm DFI,and the rates of sperm nucleoprotein immaturity,normal fertilization,good-quality embryos,blastocyst formation and embryo implantation.Results:Statistically significant differences were found between the high and low DFI-ICSI groups in the rate of embryo implantation (31.25 vs 52.50％,P ＜ 0.01) but not in the rates of normal fertilization ([65.38 ± 24.62] vs [73.00 ± 17.00] ％,P ＞ 0.05),goodquality embryos ([62.41 ± 25.97] vs [73.00 ± 22.10]％,P ＞0.05),or blastocyst formation ([62.55 ± 25.21] vs [64.30 ± 18.60] ％,P ＞ 0.05).The rate of embryo implantation was markedly higher in the high DFI-PGS than in the high DFI-ICSI group (60.97％ vs 31.25％,P ＜0.01),but there were no statistically significant differences between the two groups in the ages of the males and females,the levels of FSH,LH and T in the males,sperm concentration,the percentages of PMS and MNS,sperm DFI,sperm nucleoprotein immaturity,or the rates of normal fertilization ([69.76 ± 15.82] vs [65.38 ± 24.62] ％,P ＞0.05),goodquality embryos ([64.42 ± 30.75] vs [62.41 ± 25.97] ％,P ＞ 0.05) and blastocyst formation ([67.53 ± 19.24] vs [62.55 ± 25.21] ％,P ＞ 0.05).Conclusion:For the infertile patients with sperm DFI ≥ 15％,PGS-ICSI,rather than ICSI alone,can significantly increase the rate of embryo implantation.