Influence On The Spermatozoa And Outcome Of IVF-ET Treatment In The Male Adults With Chronic HBV Infection

BackgroudsChina is the county with high prevalence of hepatitis B virus (HBV) infectionand the positive rate of hepatitis B surface antigen (HBsAg) was about 9.75% in totalpopulation. And the positive rate of HBsAg was 12% to 17% in Guangdong, Guangxiand Hainan provinces. The family gathering phenomenon of HBV infection deeplymakes scientists devote to study vertical transmission of HBV. The possibility of thatHBV could be vertically transmitted from parents to offspring via infected germ cellsand the influence on the spermatozoa in the male adults with chronic HBV infectionare important research directions. The presence of HBV DNA sequence in the semen,spermatozoa and ova was reported, also, the integrated HBV DNA sequence inhuman sperm genome was found, but its precisely existing form, the mechanism ofappearance in semen and spermatozoa, pathologic and epidemiological significanceshould be further investigated.In recent years, assisted reproductive technology (ART) is widely carried out inthe big cities in China. The positive rate of HBsAg in infertile couples is not lowerthan that in population, and the chronic HBV infection is not contraindication of ART.The vertical HBV transmission from mother to offspring as an important route of transmission has well been documented, and largely prevented. The influence on thespermatozoa and the outcome of in vitro fertilization-embryo transfer (IVF-ET)treatment in the male adults with chronic HBV infection has rarely been reported. Itshould be paid more attention in reproductive medicine field to whether HBV insemen can infect the female and whether spermatozoa with free or integrated HBVDNA have certain influenced on the insemination, embryonic nidation anddevelopment when artificial insemination (AI) and IVF-ET are performed.Objectives1 To investigate whether HBV can infect spermatozoa or not; To evaluate thepossible correlation between the status of HBV infection load in sera,seminal plasma and spermatozoa by quantitative detetion of HBV DNA load.2 To evaluate the influence on the outcome of IVF-ET treatment in the infertilecouple whose husband with chronic infection of HBV. Methods1 HBV DNA sequence in the samples of sera, seminal plasma andspermatozoa from 58 cases with chronic HBV infection and 8 cases withnegtive hepatitis B virus markers(HBVM) were detected by fluorescencequantitative polymerase chain reaction (FQ-PCR). The differences of thequantitative results were analyzed to explore the possible influences of HBVin sera on the spermatozoa.2 A comprehensive analysis was conducted between the study group including132 infertile couples whose husbands were positive for HBsAg and wiveswere negative for HBsAg, and control group including 264 infertile couplesnegative for HBsAg in both husbands and wives. The cumulative embryoscore(CES), fertilization rate, cleavage rate, rate of embryo at good quality,implantation rate, rate of clinical pregnancy, miscarriage rate during first trimester, miscarriage rate at late pregnancy, delivery rate and rate ofneonatal malformation were carefully counted and compared between thetwo groups. Results1 The positive rate of HBVDNA in sera was 39.7% (23/58) with an averagequantity of 8.04xl0~6cp/ml, in seminal plasma was 12.1% (7/58) with anaverage quantity of 1.62x10~5 cp/ml and in spermatozoa was 8.6%(5/58)withan average quantity of 51.07cp/10~5cells (2.41*10~4cp/ml) in experimentalgroup. Five cases positive for HBV DNA in spermatozoa were foundpositive for HBV DNA in their sera and seminal plasma samples. Two caseswere positive for HBV DNA in sera and seminal plasma samples butnegative in their spermatozoa. Sixteen cases were posotive for HBV DNA insera but negative in seminal plasma and spermatozoa. Thirty-five cases ofexperimental group and eight cases of control group were both negative forHBV DNA in all three kinds of samples from sera, seminal plasma andsperm cell.2 The results revealed a significant difference of HBV DNA load among sera,seminal plasma and spermatozoa (x2 =43.053, df=2, P=0.000). HBV DNAload was the highest in sera, middle in seminal plasma and low inspermatozoa. There were positive rank correlation on HBV DNA loadamong sera, seminal plasma and spermatozoa (P<0.05) .3 Compared study group with control group, the cumulative embryo score(51.7±18.1 vs 55.1±16.5), insemination rate (68.3% vs 65.8%), cleavagerate(96.9% vs 96.9%), rate of good quality embryo (33.5% vs 35.1%),implantation rate (37.5% vs 35.0%), rate of clinical pregnancy (53.0% vs49.2%), miscarriage rate during first trimester (5.7% vs 4.5%), miscarriage rate at late pregnancy (7.1% vs 3.7%), delivery rate(39.4% vs 46.2%), andneonatal malformation rate (0 vs 0) were no significant difference (P>0.05). Conclusions1 Parts of seminal plasma and spermatozoa were infected with HBV DNA inthe male adults with chronic infection of HBV.2 Higher load of sera HBV DNA, more easily to find out HBV DNA inspermatozoa in parts of cases with chronic HBV infection.3 The male adults with chronic infection of hepatitis B virus might not affectthe outcome of IVF-ET treatment.