母體B肝帶原較容易不孕, 接受IVF-ET後胚胎著床率較低 

ertil Steril. 2019 May 15. pii: S0015-0282(19)30322-X. doi: 10.1016/j.fertnstert.2019.03.039. [Epub ahead of print]

Maternal chronic hepatitis B virus infection does not affect pregnancy outcomes in infertile patients receiving first in vitro fertilization treatment.

Wang L1, Li L2, Huang C1, Diao L1, Lian R1, Li Y1, Xiao S1, Hu X1, Mo M1, Zeng Y3.

Abstract

OBJECTIVE:

To evaluate whether maternal chronic hepatitis B virus (HBV) infection affects pregnancy outcomes in infertile patients undergoing their first in vitro fertilization (IVF) treatment.

DESIGN:

A retrospective case control study.

SETTING:

Fertility center.

PATIENT(S):

Female patients, comprising 8,550 infertile women including 180 HBsAg+HBeAg+, 714 HBsAg+HBeAg-, and 7,656 HBsAg seronegative controls undergoing their first IVF treatments.

INTERVENTION(S):

Clinical characteristics, pregnancy and neonatal outcomes were analyzed by Kruskal-Wallis test, analysis of variance, or chi-square test. Logistic regression was employed to verify the contribution of maternal HBV to clinical pregnancy, live birth, and miscarriage.

MAIN OUTCOME MEASURE(S):

Primary outcome: live-birth rate; secondary outcomes: implantation, clinical pregnancy, and miscarriage rates.

RESULT(S):

An increased duration of infertility and more secondary infertility and ovulatory disorders were observed in the HBV patients. The implantation rate was statistically significantly lower in the HBsAg+HBeAg- group compared with the controls. However, the clinical pregnancy rate, miscarriage rate, live-birth rate, neonatal outcomes, and pregnancy complications showed no statistically significant differences among the groups. The logistic regression analysis showed that HBV infection status did not affect the clinical pregnancy, miscarriage, or live-birth rates, unlike maternal age, endometrial thickness, and use of high-quality embryos.

CONCLUSION(S):

Hepatitis B virus infection is not an independent contributor to pregnancy outcomes, although it is associated with prolonged infertility duration, a high frequency of secondary infertility and ovulatory disorders, and a reduced implantation rate.