Influence Of Female Chronic Hepatitis B Virus Infection On Outcomes Of In Vitro Fertilization And Embryo Transfer Treatment

[Objective]To explore the relationship between the HBV DNA load of female chronic HBV(Hepatitis B virus) infection and outcomes of IVF-ET(in vitro fertilization-embryo transfer).[Methods]A total of 432 infertile couples undergoing their first IVF-ET cycle were enrolled, which included 216 couples with female partners being HBsAg-seropositive and 216 couples with both HBsAg-seronegative served as controls. The patients were assigned to four groups according to the infection condition of HBV and the HBV DNA load: group A(n=35):female chronic HBV infection with HBV DNA≥1.0×105IU/ml; group B(n=124):female chronic HBV infection with 1.0×105IU/ml>HBV DNA≥ 5.0×102IU/ml; group C(n=57):female chronic HBV infection with HBV DNA<5.0 ×102IU/ml; group D(n=216):couples with both HBsAg-seronegative served as controls. A retrospective analysis were performed on the fertilization rate, top-quality embryo rate, implantation rate, clinical pregnancy rate, miscarriage rate, live birth rate between the 4 groups. Take a multiple linear regression analysis to research the correlation between serum HBV DNA loads and fertilization rate with top-quality embryo rate and take a logistic regression analysis to research the influencing factor of the first IVF-ET cycle in female chronic HBV infection with HBV DNA≥5.0× 102 IU/ml.[Results]1、The demographics in the first IVF cycle, including the age, duration of infertility, body mass index(BMI), basal FSH, basal E2, cause of infertility were similar between the 4 groups (P>0.05). The dosage of gonadotrophin used, the endometrial thickness on the day of hCG (human chorionic onadotrophin) injection, the mean number of oocytes retrieved were no significant difference(P>0.05).Group A had lowest fertilization rate and top-quality embryo rate (68.32±15.32,33.56±18.94, respectively, P<0.05). Group B had lower fertilization rate and top-quality embryo rate (72.54±12.95,39.65±15.48, respectively, P<0.05). Group C and group D had the same fertilization rate and top-quality embryo rate(77.33±15.83 vs78.93±19.74, 46.17±12.42 vs 48.47±19.74, respectively, P>0.05). There were no significant difference in the number of embryos transferred and the number of top-quality embryos transferred. The implantation rate(23.44% vs 25.97% vs 28.04% vs 29.71%, respectively), clinical pregnancy rate(39.40%vs 40.68% vs 44.44% vs 45.20%, respectively), miscarriage rate(15.38% vs 16.67% vs 12.50% vs 13.83%,respectively), live birth rate(30.30% vs 33.05% vs 35.19% vs 34.62%,respectively) and cancelled cycle rate were not statistically different between the 4 groups.2、In the female chronic HBV infection with HBV DNA≥5.0×102 IU/ml and between 20-37 years, there is a negative correlation between the fertilization rate and age(β=-2.768, P<0.01) and serum HBV DNA loads (β=-0.339, P<0.01), a negative correlation between the top-quality embryo rate and age ( β=-5.436, P <0.01) and serum HBV DNA loads(β=-1.857, P<0.05) by the multiple linear regression analysis.3、The age(OR=0.932, P<0.05), the number of embryo transfer(OR= 1.874, P <0.05) and the number of top-quality embryo transfer (OR=2.719, P<0.05) had a correlation between clinical pregnancy outcome, the clinical pregnancy outcome was not related to serum HBV DNA loads by the logistic regression analysis in the female chronic HBV infection with HBV DNA≥5.0×102 IU/ml and between 20-37 years.(Conclusions]1、During the first IVF-ET cycle, the fertilization rate and top-quality embryo rate had the negative correlation between the serum HBV DNA loads when the female chronic HBV infection with HBV DNA≥5.0×102 IU/ml. The fertilization rate and top-quality embryo rate were similar in female chronic HBV infection with HBV DNA<5.0×102IU/ml and couples with both HBsAg-seronegative.2、There were no differences in implantation rate, clinical pregnancy rate, miscarriage rate, live birth rate and cancelled cycle rate between the female HBsAg-seropositive with any HBV DNA load and couples with both HBsAg-seronegative during their first IVF-ET cycle...