上海交通大学学报（医学版）

上海交通大学学报（医学版） ›› 2018, Vol. 38 ›› Issue (10): 1229-.doi: 10.3969/j.issn.1674-8115.2018.10.017

• 论著·临床研究 • 上一篇    下一篇

男性叶酸代谢功能与辅助生殖技术结局的相关性研究

吴正沐 1，陈松长 2，徐晨明 2，金丽 1   

  1. 1.上海交通大学医学院附属国际和平妇幼保健院辅助生殖科，上海 200030；2.上海交通大学医学院附属国际和平妇幼保健院生殖遗传科，上海 200030
  • 出版日期:2018-10-28 发布日期:2018-11-18
  • 通讯作者: 金丽，电子信箱：jinli96@163.com。
  • 作者简介:吴正沐（1979—），男，副主任医师，硕士；电子信箱： wuzhengmu@126.com。

Association between folate metabolism in males and outcome of assistant reproductive technology

WU Zheng-mu1, CHEN Song-chang2, XU Chen-ming2, JIN Li1   

  1. 1. Department of Reproductive Medicine, International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China; 2. Key Laboratory of Reproductive Genetics, International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China
  • Online:2018-10-28 Published:2018-11-18

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摘要： 目的 ·研究男性叶酸代谢相关基因亚甲基四氢叶酸还原酶（ methylenetetrahydrofolate reductase，MTHFR）C677T多态性及同型半胱氨酸（ homocysteine，HCY）水平对辅助生殖技术（ assisted reproductive technology，ART）妊娠结局的影响。方法 ·观察接受辅助生殖治疗的 285对不孕不育夫妇，收集男方精液质量、血清 HCY浓度和 MTHFR基因型等资料，并对他们助孕情况进行回顾性分析。根据 HCY水平分为高 HCY组和正常 HCY组，根据 MTHFR基因型结果分为叶酸代谢障碍高风险（ TT）组和非 TT组，两两组合，以非 TT正常 HCY组为参照组进行比较。结果 ·各组精液质量对比差异无统计学意义（ P>0.05）。非 TT高 HCY组及 TT高 HCY组与参照组比较，受精率显著降低（ P0.001，P0.002）；非 TT高 HCY组的优胚率明显低于参照组（ P0.038）。妊娠率及流产率差异无统计学意义（ P>0.05）。结论 ·高 HCY血症可能会影响辅助生殖技术的受精率， MTHFR基因多态性的检测结果有助于提醒受孕人群及时补充叶酸。

关键词: 亚甲基四氢叶酸还原酶, 同型半胱氨酸, 辅助生殖技术, 结局

Abstract:

Objective · To investigate the association between polymorphisms in methylenetetrahydrofolate reductase (MTHFR), serum homocysteine (HCY) concentration and outcome of assistant reproductive technology (ART). Methods · A retrospective study was conducted in 285 infertile couples who underwent ART. Sperm quality, serum HCY concentration and MTHFR genotype of the males in these couples were collected. According to the results of MTHFR C677T and serum HCY of males, they were divided into four groups, i.e, TT+high HCY, TT+normal HCY, NOT TT+high HCY, and NOT TT+normal HCY (as control). Results · There was no significant difference in the frequency distribution of oligoasthenozoospermia of four groups (P>0.05). The fertilization rates were significantly lower in patients with high plasma HCY levels (P<0.05). The rates of effective embryo in NOT TT+high HCY group were significantly lower (P<0.05). Accumulated pregnancy rates and early abortion rates were not significantly different among four groups (P>0.05). Conclusion · High serum HCY of males may affect outcome of ART. The detection of MTHFR gene polymorphisms helps to remind supplement folic acid in time.

Key words: methylenetetrahydrofolate reductase, homocysteine, assistant reproductive technology, outcome

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