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Objective To investigate the correlation between semen parameters with spontaneous abortion in early pregnancy after in vitro fertilization (IVF) assisted pregnancy operation .Methods 220 patients with successful pregnancy after IVF assisted pregnancy operation in the reproductive center of this hospital were selected as the research subjects .Among them ,40 cases of early spontaneous abortion served as the observa-tion group and 180 cases without early spontaneous abortion occurrence as the control group .The related pa-rameters of sperm hyaluronic acid unbinding rate ,sperm nucleoprotein immaturity rate and sperm morphology normal rate were measured and analyzed by adopting the computer assisted sperm analysis (CASA) .Results The sperm hyaluronic acid unbinding rate and sperm nucleoprotein immaturity rate in the observation group were significantly higher than those in the control group ,the difference was statistically significant ( P<0 .05);the sperm morphology normal rate in the observation group was significantly lower than that in the control group ,the difference was statistically significant (P<0 .05);the other semen parameters had no statis-tical differences between the two groups (P>0 .05) .The statistical analysis result showed that the sperm hy-aluronic acid unbinding rate ,sperm DNA fragmentation rate and sperm nucleoprotein immaturity had the posi-tive correlation between each other ,which had the negative correlation with the other indicators .After the stepwise analysis by the binary Logistic regression model ,the results showed that the high risk factors affect-ing spontaneous abortion in early pregnancy after IVF included sperm nucleoprotein immaturity rate and sperm hyaluronic acid unbinding rate .Conclusion The sperm nucleoprotein immaturity rate and sperm hyalu-ronic acid unbinding rate are two high-risk factors inducing early spontaneous abortion after IVF .
ABSTRACT
<p><b>Objective</b>To investigate the effects of the DNA fragmentation index (DFI) and malformation rate (SMR) of optimized sperm on embryonic development and early spontaneous abortion in conventional in vitro fertilization and embryo transfer (IVF-ET).</p><p><b>METHODS</b>We selected 602 cycles of conventional IVF-ET for pure oviductal infertility that had achieved clinical pregnancies, including 505 cycles with ongoing pregnancy and 97 cycles with early spontaneous abortion. On the day of ovum retrieval, we examined the DNA integrity and morphology of the rest of the optimized sperm using the SCD and Diff-Quik methods, established the joint predictor (JP) by logistic equation, and assessed the value of DFI and SMR in predicting early spontaneous abortion using the ROC curve.</p><p><b>RESULTS</b>The DFI, SMR, and high-quality embryo rate were (15.91±3.69)%, (82.85±10.24)%, and 46.53% (342/735) in the early spontaneous abortion group and (9.30±4.22)%, (77.32±9.19)%, and 56.43% (2263/4010) respectively in the ongoing pregnancy group, all with statistically significant differences between the two groups (P<0.05 ). Both the DFI and SMR were the risk factors of early spontaneous abortion (OR = 5.96 and 1.66; both P< 0.01). The areas under the ROC curve for DFI, SMR and JP were 0.893±0.019, 0.685±0.028, and 0.898±0.018, respectively. According to the Youden index, the optimal cut-off values of the DFI and SMR obtained for the prediction of early spontaneous abortion were approximately 15% and 80%. The DFI was correlated positively with SMR (r= 0.31, P<0.01) but the high-quality embryo rate negatively with both the DFI (r= －0.45, P<0.01) and SMR (r= －0.22, P<0.01).</p><p><b>CONCLUSIONS</b>The DFI and SMR of optimized sperm are closely associated with embryonic development in IVF. The DFI has a certain value for predicting early spontaneous abortion with a threshold of approximately 15%, but SMR may have a lower predictive value.</p>
Subject(s)
Abortion, Spontaneous , DNA Fragmentation , Embryo Transfer , Embryonic Development , Female , Fertilization in Vitro , Humans , Infertility , Male , Pregnancy , ROC Curve , Risk Factors , Spermatozoa , PathologyABSTRACT
Aims: To assess the association between FVL G1691A, FII G20210A, MTHFR A1298C, C677T and PAI-1 5G/675/4G gene polymorphisms among women with unexplained recurrent early spontaneous abortion (URESA) Materials and Methods: This study included two groups of Russian women: 50 currently nonpregnant women with a history of 2-5 unexplained recurrent early spontaneous abortion and unknown causes of miscarriages (URESA group), and 50 currently non-pregnant women with a history of having given birth to at least one live baby and without a history of spontaneous abortion, prematurity, stillbirth, eclampsia and other pregnancy complications (control group). Gene polymorphisms were detected by the technique of polymerase chain reaction-real time (PCR-RT). We have analyzed the frequencies, χ2 test, odds ratio (OR) and its 95% confidence interval (CI), Hardy-Weinberg equilibrium. Results: Significant association between heterozygotes genotype FVL 1691G/A and URESA was found (OR=3.1). Heterozygous genotype FII20210G/A was associated mainly with recurrent spontaneous abortions (4% vs 0%). The PAI-1 5G/4G genotype was significantly associated with URESA (OR=2.3). Heterozygotes with MTHFR 677C/T genotype had high risk of early recurrent pregnancy loss (OR=4.6). Heterozygotes with MTHFR 1298A/C genotype showed low association with pregnancy loss (OR=1.2). We did not observe increased risk of early pregnancy loss in mutant homozygotes with MTHFR 677C/C and 1298C/C genotypes (OR=1.0). The presence of the PAI-1 gene 5G/4G genotype together with the MTHFR 677C/T or MTHFR 1298A/C or FVL 1691G/A genotypes was found to be a risk factor for URESA (OR=4.5; OR=2.3, respectively). Combined PAI-1 5G/4G// FVL 1691G/A genotypes was detected only in patients (2% vs 0%). Women carrying combined PAI-1 5G/4G//MTHFR 677C/T//MTHFR 1298A/C genotypes had an increased frequency of recurrent early spontaneous abortion (OR=1.4). Conclusion: The genetic polymorphisms of FVL 1691G/A, FII 20210G/A, MTHFR 677C/T, MTHFR 1298A/C, and PAI-1 4G/4G, and the PAI-1 5G/4G genotypes are associated with URESA. The patients carrying combined heterozygous genotypes PAI-1 5G/4G//MTHFR 677C/T or PAI-1 5G/4G//MTHFR 1298A/C or PAI-1 5G/4G//FVL 1691G/A or PAI-1 5G/4G//MTHFR 677C/T//MTHFR 1298A/C have higher risks of URESA. These results might indicate a genetic influence on pathogenesis of URESA.
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Objective To examine the cellular distribution and expression,activation of nuclear factor ?B(NF-?B) in the tissuses of chorion of early spontaneous abortion,and explore the relationship between early spontaneous abortion and NF-?B.Methods The NF-?B expression on the chorionic villi was analyzed by S-P immunohistochemistry.The nucleoplasmic ratio of NF-?B was detected by laser scanning confocal microscope.Results The expression intensity of NF-?B in the syncytiotrophoblasts was significantly weaker in women with early spontaneous abortion than in the normal early pregnancy(P