| Objective To investigate the effects of hepatitis B virus(HBV)infection on the fertility of IVF/ICSI-ET couples and the effects of different infection patterns on embryonic development and pregnancy outcomes of IVF/ICSI-ET.Methods A retrospective analysis was conducted from May 2015 to May 2018 at the Reproductive Medicine Center of General Hospital of Ningxia Medical University,in which records for a total of 305 cycles of the IVF/ICSI-ET infertility patients who are the first-time receiver of IVF/ICSI-ET are given.Male and female patients were divided into HBV-infected group and uninfected group depending on whether hepatitis B virus is infected;HBV-infected patients were further divided into HBV-DNA positive group and HBV-DNA negative group according to HBV-DNA results;According to the HBV marker model,HBV infected patients were divided into Hepatitis BHBe Ag,Three positive and other infection mode groups.According to the HBV infection of both husband and wife,the disease carriers are divided into different groups as follow: Group A:the female HBV infection group,Group B:only the male HBV infection group,Group C:both infected groups and Group D:neither side was infected;The HBV-DNA of the infected couples was divided into Only female HBV-DNA positive group,Only male HBV-DNA positive group,both HBV-DNA positive groups and the control group.Base parameters,embryo development,and pregnancy outcomes were compared between groups.General conditions include ages of couples,years of infertility,type of infertility(primary or secondary),body mass index(BMI),anti-Mullerian hormone(AMH),basic endocrine level,and analysis of male semen.To study the effect of HBV on fertility of males and females and whether there were differences in fertilization rate,number of cleavage,rate of excellent embryos,clinical pregnancy rate and abortion rate in different infection mode groups.Results1.The effect of HBV on male semen quality1.1 Comparison of semen quality between male HBV infection group and uninfected group The sperm density,survival rate,forward activity rate and total activity rate of male patients infected with HBV were significantly lower than those of the uninfected group(72.32±50.62 VS 88.81±49.08,50.12±18.02 VS 55.75±15.67,20.06±10.60 VS 22.99±10.02).48.36±16.50 VS 54.77±27.59,P<0.05).1.2 Comparison of semen quality between male HBV-DNA and non-infected groups The sperm density,survival rate and normal morphological rate of HBV-DNA positive group were significantly lower than those of uninfected hepatitis B virus group(70.10±50.05 VS88.81±49.08,48.70±17.67 VS55.75±15.67,5.22±3.70 VS6.24±3.63).,P<0.05);The sperm density of the HBV-DNA negative group was significantly lower than that of the uninfected hepatitis B virus group(80.90±61.91 VS88.81±49.08,P<0.05).The HBV-DNA positive group was compared with the HBV-DNA negative group.There were no significant differences in semen parameters(P>0.05).1.3 Comparison of semen quality in male patients with different combinations of HBV markers The sperm density,survival rate,normal morphology rate,PR,PR+NP of the male hepatitis B group were significantly lower than those of the uninfected group(63.01±47.42 VS88.81±49.08,47.79±21.61 VS 55.75±15.67,5.16±6.99.VS 6.24±3.63,19.88±13.61 VS22.99±10.02,48.20±19.67 VS 54.77±27.59,P<0.05);the normal sperm morphology,PR and PR+NP of patients with hepatitis B small Sanyang group were significantly lower than those of the uninfected group(5.25±2.31 VS 6.24±3.63,19.43±9.81 VS 22.99±10.02,46.96±15.74 VS 54.77±27.59,P<0.05)There was no significant difference in semen quality between the other infected groups and the uninfected group,and the infection group with different hepatitis B marker combinations There was no significant difference in semen quality between the two.2.The effect of hepatitis B virus infection on female fertility2.1 Comparison of general conditions and COH outcomes between female HBV-infected and uninfected groups.There was no significant difference in ovarian function and COH outcome between the two groups when there was no significant difference in age,infertility time and basal hormone level between the two groups of HBV-infected women and non-infected women.(P > 0.05).2.2 Different HBV-DNA load group and uninfected group of women in general and COH comparison The infertility time of the female HBV-DNA positive group was significantly greater than that of the HBV-DNA negative group and the female group without HBV infection(5.55±4.47 VS3.50±2.67,4.37±3.84,P<0.05);other indicators such as age,infertility type,b FSH,b E2,b FSH/b LH,AMH,number of eggs obtained,egg maturation rate,etc.among the three groups There was no significant difference in the difference(P > 0.05).2.3 Comparison of general conditions and COH outcomes between infected and control groups of different HBV markers in women There was no significant difference in infertility years,basal hormone level,ovarian function and COH outcome among the three groups.(P > 0.05).3.The effect of different combinations of HBV infection patterns on the outcome of IVF/ICSI-ET3.1 Comparison of different infection mode groups of HBV between husband and wife and control group The infertility time of group C was significantly higher than that of group A and group D(5.41±4.45 VS 3.96±2.82,3.78±2.72,P<0.05);the fertilization rate and cleavage rate of group C were significantly lower than group D.(80.52% vs 88.25%,47.09% vs 57.06%,83.39% vs94.30%,P<0.05);the cleavage rate of group B was significantly lower than that of group D(89.61% vs 94.30%,P<0.05);There was no significant difference in AMH,excellent embryo rate,clinical pregnancy rate,abortion and other pregnancy outcomes(P>0.05).3.2 Comparison of different HBV-DNA combination patterns between the husband infected group and the wife infected group and the control group.The AMH of the HBV-DNA positive group was significantly lower than that of the female HBV-DNA positive group(3.16±1.60 VS5.12±5.39,P<0.05);only the male HBV-DNA positive couple group,the fertilization rate and The cleavage rate was significantly lower than that of the control group(78.63% vs 88.25%,83.87% vs 94.30%,P<0.05);the cleavage rate of the couples with positive HBV-DNA was significantly lower than that of the control group(86.15% vs 94.30).%,P < 0.05);there was no significant difference in pregnancy outcome between the four groups.Conclusion1.Male HBV infection affects sperm density,survival rate,normal morphology rate and motility;and has a negative impact on fertilization rate and cleavage rate after IVF/ICSI treatment.2.After HBV infection in women,HBV-DNA positive prolongs the infertility time of patients;HBV infection has no significant effect on ovarian function and embryonic development of assisted reproductive therapy.3.There was no significant difference in pregnancy outcome of IVF/ICSI-ET between the couple's in different HBV infection modes. |
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