男性乙型肝炎病毒感染与IVF/ICSI妊娠结局的关系

目的:探讨男性在乙型肝炎病毒感染期及恢复期接受IVF/ICSI对妊娠结局是否造成影响。方法:回顾性分析首次接受IVF/ICSI治疗的496对不孕夫妇,术前进行血清HBV及乙肝5项检测,女方乙肝5项均为阴性或仅HbsAb阳性且HBV-DNA阴性。根据男方乙肝检查结果分成3组,A组(297对夫妇):男方乙肝5项均为阴性或仅HbsAb阳性且HBV-DNA阴性;B组(81对夫妇):男方乙肝大三阳且HBV-DNA阳性;C组(118对夫妇):男方乙肝小三阳且HBV-DNA阴性。统计分析3组第1次新鲜周期治疗情况及妊娠结局,并进一步比较3组中行ICSI周期的临床结局。结果:在IVF/ICSI周期中A、B、C组女方的临床妊娠率(40.1%vs47.9%vs 36.7%)、早期流产率(8.3%vs 8.6%vs 2.5%)无统计学差异;早产率、抱婴回家率(34.2%vs 42.5%vs 33.9%)和婴儿出生情况各组间亦相似。在ICSI周期中,3组的临床妊娠率、早期流产率、抱婴回家率及婴儿出生情况亦无统计学差异(P>0.05)。结论:男性在乙肝病毒感染期和恢复期无论采用IVF或ICSI方式授精,对妊娠结局及婴儿出生情况均无不良影响。

Outcomes of IVF/ICSI in Male with Hepatitis B Infection

Objective: To examine whether men with hepatitis B would impact the IVF/ICSI outcomes.Methods: A retrospective study concerned 496 infertility couples receiving the first time IVF/ICSI who were tested serum HBV-DNA and HBsAb,HBsAg,HBeAg,HBeAb,HBcAb.All wives were negative in both HBV-DNA and HBV markers or only HBsAg positive.All the couples were divided into 3 groups by males’results.Group A(297 couples): female and male were negative in both HBV-DNA and five markers of hepatitis B or only HBsAb positive;group B(81 couples): male HBV-DNA,HBsAg,HBcAb and HBeAg were all positive;group C(118 couples): male’s HBV-DNA was negative and HBsAg,HBcAb and HBeAb were all positive.IVF/ICSI fresh cycle outcomes were analysed in each group.Results: In IVF/ICSI cycles,groups A,B,C had similar results in clinical pregnancy rate(40.1%,47.9%,36.7%,respectively,P>0.05),early miscarriage rate(8.3% vs 8.6% vs 2.5%,P>0.05) and baby taking home rate(34.2% vs 42.5% vs 33.9%,P>0.05).In ICSI cycles,clinical pregnancy rate,early miscarriage rate and baby taking home rate were similar(P>0.05).Conclusion: Men with hepatitis B,whether he is in infection period or recovery period will not affect the outcomes of IVF/ICSI.