PENGARUH FRAGMENTASI DNA SPERMA TERHADAP ANGKA FERTILISASI DAN EMBRIOGENESIS
Abstract
Latar Belakang: Pemeriksaan fragmentasi DNA sperma sudah mulai banyak digunakan dalam upaya memperoleh keturunan pada pasangan subfertil yang mengikuti program bayi tabung. Pemeriksaan sperm chromatin dispersion merupakan salah satu pemeriksaan dengan metodologi yang simpel dan relatif mudah dilakukan untuk kepentingan klinis.
Tujuan: untuk mengetahui pengaruh fragmentasi DNA sperma terhadap angka fertilisasi dan embriogenesis.
Metode: Penelitian observasional ini dilakukan dengan mengambil sampel semen pria dari pasangan infertil yang mengikuti program IVF-ICSI, dilakukan pemeriksaan analisis sperma WHO dan penilaian indeks fragmentasi DNA sperma. Setelah dilakukan ICSI kemudian dilakukan penilaian fertilisasi dan embriogenesis. Selanjutnya dilakukan analisis dengan menghitung korelasi. Rancangan penelitian adalah cross sectional untuk melihat korelasi antara indeks fragmentasi DNA sperma dengan angka fertilisasi dan embriogenesis. Untuk analisis beda rerata 2 kategori menggunakan independent sample t-test sedangkan yang lebih dari 2 kategori memakai anova. Analisis untuk jenis variabel kategorikal menggunakan chi-square test.
Hasil: Pada periode penelitian selama 10 bulan, jumlah subyek penelitian yang sesuai dengan kriteria inklusi adalah 29 pasangan infertil dengan 29 sampel sperma ejakulat dan 200 oosit. Dari analisis indeks fragmentasi DNA sperma dengan angka fertilisasi terlihat bahwa fertilisasi yang baik (Z1 dan Z2) lebih banyak terdapat pada kelompok dengan indeks fragmentasi DNA sperma £30%, dan berbeda bermakna secara statistik dengan p<0.05, dan dari analisis indeks fragmentasi DNA sperma dengan skoring embrio terlihat skoring embrio yang lebih baik (grade A dan B) pada kelompok indeks fragmentasi DNA sperma £30%, yang tidak bermakna secara statistik.
Kesimpulan: Angka fragmentasi DNA sperma dapat menunjukkan hubungan negatif dengan angka fertilisasi tetapi tidak dapat menunjukkan hubungan yang bermakna secara statistik dengan angka embriogenesis. Terlihat hubungan yang bermakna secara statistik antara parameter analisis sperma WHO dengan indeks fragmentasi DNA yang diperiksa menggunakan metode SCD.
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