男性乙型肝炎病毒感染与IVF/ICSI妊娠结局的关系

Outcomes of IVF/ICSI in Male with Hepatitis B Infection

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。

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,P0.05）,early miscarriage rate（8.3% vs 8.6% vs 2.5%,P0.05） and baby taking home rate（34.2% vs 42.5% vs 33.9%,P0.05）.In ICSI cycles,clinical pregnancy rate,early miscarriage rate and baby taking home rate were similar（P0.05）.Conclusion： Men with hepatitis B,whether he is in infection period or recovery period will not affect the outcomes of IVF/ICSI.