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Liu F, Wang Z, Song Y, Tian T, Li R, Qiao J, Huang S, Wang Y. The impact of HBV, HCV, or syphilis infections on embryo and pregnancy outcomes in couples undergoing IVF treatment: a matched cohort study. Hum Reprod Open 2025; 2025:hoaf015. [PMID: 40171332 PMCID: PMC11961197 DOI: 10.1093/hropen/hoaf015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2024] [Revised: 02/17/2025] [Indexed: 04/03/2025] Open
Abstract
STUDY QUESTION Do infectious diseases (hepatitis B virus [HBV], hepatitis C virus [HCV], and syphilis) impact embryo quality, pregnancy, and neonatal outcomes following a complete IVF cycle? SUMMARY ANSWER Infections with HBV, HCV, or syphilis do not have detrimental impacts on live birth rates or neonatal outcomes in couples following a complete IVF cycle. WHAT IS KNOWN ALREADY Maternal or paternal infections with HBV, HCV, or syphilis may decrease the clinical pregnancy rate, result in poorer embryo outcomes, and lower offspring birth weight. However, there is significant controversy regarding these effects across existing studies, highlighting the need for further research. STUDY DESIGN SIZE DURATION This is a retrospective matched cohort study. Data were obtained from the clinical database of couples who underwent IVF treatment at a single academically affiliated fertility clinic from January 2011 to December 2019, with follow-up extending to December 2020. Out of 180 666 complete cycles recorded, 2443 cycles fulfilled our inclusion criteria. PARTICIPANTS/MATERIALS SETTING METHODS In cycles that fulfilled our inclusion criteria, there were 1997 cycles in the HBV study group, 154 cycles in the HCV study group, and 292 cycles in the syphilis study group. Each study cycle was paired with four controls based on participant age and the timing of IVF treatment, resulting in 7988 controls for the HBV group, 616 controls for the HCV group, and 1169 controls for the syphilis group. Infections could be either single-parent or biparental. The primary outcome was live birth per complete cycle (i.e. fresh cycle plus subsequent frozen-thawed cycles). Subgroup analyses were conducted dividing cycles into maternal infection and paternal infection. MAIN RESULTS AND THE ROLE OF CHANCE In the HBV group, pregnancy outcomes (clinical pregnancy, miscarriage, and live birth rates) and neonatal birth weight were similar to that of the controls. In the HCV group, no significant differences from the controls were observed except for a lower clinical pregnancy rate in the study group (36.4% vs 42.2%, adjusted β and 95% CI: 0.62 [0.39-0.96]). Similarly, no significant differences were found in pregnancy or neonatal outcomes between the syphilis group and the control group. As for subgroup analyses, the male-only HBV infection subgroup showed a higher miscarriage rate in the study group than in the control group (22.5% vs 17.7%, adjusted β and 95% CI: 1.56 [1.07-2.28]). For the HCV and syphilis subgroups, none of the outcomes showed significant differences between either the female-only infection or male-only infection subgroups and the controls. LIMITATIONS REASONS FOR CAUTION Although potential confounders were considered and adjusted for, residual bias may still exist due to the study design. The inclusion of participants solely from a single center limited the generalizability of our findings to a broader context. WIDER IMPLICATIONS OF THE FINDINGS We presented a comprehensive overview of the impact of prevalent infectious diseases on IVF outcomes, hoping to address uncertainties surrounding the decisions of couples infected with these diseases and to assist in preventing adverse reproductive outcomes in clinical practice. STUDY FUNDING/COMPETING INTERESTS This study was supported by the National Natural Science Foundation of China (82204052), the National Key R&D Program of China (2022YFC2705305), and the Clinical key project of Peking University Third Hospital (BYSYZD2023007). The authors declare no competing interests. TRIAL REGISTRATION NUMBER N/A.
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Affiliation(s)
- Fang Liu
- Department of Obstetrics and Gynecology, Center for Reproductive Medicine, Peking University Third Hospital, Beijing, The People’s Republic of China
- National Clinical Research Center for Obstetrics and Gynecology, Peking University Third Hospital, Beijing, The People’s Republic of China
- State Key Laboratory of Female Fertility Promotion, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, The People’s Republic of China
- Key Laboratory of Assisted Reproduction, Peking University, Ministry of Education, Beijing, The People’s Republic of China
- Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology, Peking University Third Hospital, Beijing, The People’s Republic of China
| | - Zheng Wang
- Department of Obstetrics and Gynecology, Center for Reproductive Medicine, Peking University Third Hospital, Beijing, The People’s Republic of China
- National Clinical Research Center for Obstetrics and Gynecology, Peking University Third Hospital, Beijing, The People’s Republic of China
- State Key Laboratory of Female Fertility Promotion, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, The People’s Republic of China
- Key Laboratory of Assisted Reproduction, Peking University, Ministry of Education, Beijing, The People’s Republic of China
- Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology, Peking University Third Hospital, Beijing, The People’s Republic of China
| | - Ying Song
- Department of Obstetrics and Gynecology, Center for Reproductive Medicine, Peking University Third Hospital, Beijing, The People’s Republic of China
- National Clinical Research Center for Obstetrics and Gynecology, Peking University Third Hospital, Beijing, The People’s Republic of China
- State Key Laboratory of Female Fertility Promotion, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, The People’s Republic of China
- Key Laboratory of Assisted Reproduction, Peking University, Ministry of Education, Beijing, The People’s Republic of China
- Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology, Peking University Third Hospital, Beijing, The People’s Republic of China
| | - Tian Tian
- Department of Obstetrics and Gynecology, Center for Reproductive Medicine, Peking University Third Hospital, Beijing, The People’s Republic of China
- National Clinical Research Center for Obstetrics and Gynecology, Peking University Third Hospital, Beijing, The People’s Republic of China
- State Key Laboratory of Female Fertility Promotion, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, The People’s Republic of China
- Key Laboratory of Assisted Reproduction, Peking University, Ministry of Education, Beijing, The People’s Republic of China
- Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology, Peking University Third Hospital, Beijing, The People’s Republic of China
| | - Rong Li
- Department of Obstetrics and Gynecology, Center for Reproductive Medicine, Peking University Third Hospital, Beijing, The People’s Republic of China
- National Clinical Research Center for Obstetrics and Gynecology, Peking University Third Hospital, Beijing, The People’s Republic of China
- State Key Laboratory of Female Fertility Promotion, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, The People’s Republic of China
- Key Laboratory of Assisted Reproduction, Peking University, Ministry of Education, Beijing, The People’s Republic of China
- Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology, Peking University Third Hospital, Beijing, The People’s Republic of China
| | - Jie Qiao
- Department of Obstetrics and Gynecology, Center for Reproductive Medicine, Peking University Third Hospital, Beijing, The People’s Republic of China
- National Clinical Research Center for Obstetrics and Gynecology, Peking University Third Hospital, Beijing, The People’s Republic of China
- State Key Laboratory of Female Fertility Promotion, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, The People’s Republic of China
- Key Laboratory of Assisted Reproduction, Peking University, Ministry of Education, Beijing, The People’s Republic of China
- Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology, Peking University Third Hospital, Beijing, The People’s Republic of China
| | - Shuo Huang
- Department of Obstetrics and Gynecology, Center for Reproductive Medicine, Peking University Third Hospital, Beijing, The People’s Republic of China
- National Clinical Research Center for Obstetrics and Gynecology, Peking University Third Hospital, Beijing, The People’s Republic of China
- State Key Laboratory of Female Fertility Promotion, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, The People’s Republic of China
- Key Laboratory of Assisted Reproduction, Peking University, Ministry of Education, Beijing, The People’s Republic of China
- Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology, Peking University Third Hospital, Beijing, The People’s Republic of China
| | - Yuanyuan Wang
- Department of Obstetrics and Gynecology, Center for Reproductive Medicine, Peking University Third Hospital, Beijing, The People’s Republic of China
- National Clinical Research Center for Obstetrics and Gynecology, Peking University Third Hospital, Beijing, The People’s Republic of China
- State Key Laboratory of Female Fertility Promotion, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, The People’s Republic of China
- Key Laboratory of Assisted Reproduction, Peking University, Ministry of Education, Beijing, The People’s Republic of China
- Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology, Peking University Third Hospital, Beijing, The People’s Republic of China
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Wibowo DP, Agustiningsih A, Jayanti S, Sukowati CHC, El Khobar KE. Exploring the impact of hepatitis B immunoglobulin and antiviral interventions to reduce vertical transmission of hepatitis B virus. World J Exp Med 2024; 14:95960. [PMID: 39713069 PMCID: PMC11551711 DOI: 10.5493/wjem.v14.i4.95960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2024] [Revised: 08/16/2024] [Accepted: 09/02/2024] [Indexed: 10/31/2024] Open
Abstract
Hepatitis B virus (HBV) infection is a major public health burden. In HBV endemic regions, high prevalence is also correlated with the infections acquired in infancy through perinatal transmission or early childhood exposure to HBV, the so-called mother-to-child transmission (MTCT). Children who are infected with HBV at a young age are at higher risk of developing chronic HBV infection than those infected as adults, which may lead to worse clinical outcome. To reduce the incidence of HBV MTCT, several interventions for the infants or the mothers, or both, are already carried out. This review explores the newest information and approaches available in literature regarding HBV MTCT prevalence and its challenges, especially in high HBV endemic countries. This covers HBV screening in pregnant women, prenatal intervention, infant immunoprophylaxis, and post-vaccination serological testing for children.
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Affiliation(s)
- Dhita Prabasari Wibowo
- Eijkman Research Center for Molecular Biology, Research Organization for Health, National Research and Innovation Agency of Indonesia, Jakarta 10430, Indonesia
- Postgraduate School, Faculty of Medicine, Universitas Hasanuddin, Makassar 90245, Indonesia
| | - Agustiningsih Agustiningsih
- Eijkman Research Center for Molecular Biology, Research Organization for Health, National Research and Innovation Agency of Indonesia, Jakarta 10430, Indonesia
| | - Sri Jayanti
- Eijkman Research Center for Molecular Biology, Research Organization for Health, National Research and Innovation Agency of Indonesia, Jakarta 10430, Indonesia
| | - Caecilia H C Sukowati
- Eijkman Research Center for Molecular Biology, Research Organization for Health, National Research and Innovation Agency of Indonesia, Jakarta 10430, Indonesia
- Department of Liver Cancer, Fondazione Italiana Fegato ONLUS, Trieste 34149, Italy
| | - Korri Elvanita El Khobar
- Eijkman Research Center for Molecular Biology, Research Organization for Health, National Research and Innovation Agency of Indonesia, Jakarta 10430, Indonesia
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Zhang L, Zhang F, Ma Z, Jin J. Hepatitis B virus infection, infertility, and assisted reproduction. J Zhejiang Univ Sci B 2024; 25:672-685. [PMID: 39155780 PMCID: PMC11337088 DOI: 10.1631/jzus.b2300261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Accepted: 10/23/2023] [Indexed: 08/20/2024]
Abstract
BACKGROUND: Hepatitis B virus (HBV) is one of the most widespread viruses worldwide and a major cause of hepatitis, cirrhosis, and hepatocellular carcinoma. Previous studies have revealed the impacts of HBV infection on fertility. An increasing number of infertile couples with chronic hepatitis B (CHB) virus infection choose assisted reproductive technology (ART) to meet their fertility needs. Despite the high prevalence of HBV, the effects of HBV infection on assisted reproduction treatment remain limited and contradictory. OBJECTIVE: The aim of this study was to provide a comprehensive overview of the effect of HBV infection on fertility and discuss its effects on pregnancy outcomes, vertical transmission, pregnancy complications, and viral activity during ART treatment. METHODS: We conducted a literature search in PubMed for studies on HBV infection and ART published from 1996 to 2022. RESULTS: HBV infection negatively affected fertility in both males and females. Existing research shows that HBV infection may increase the risk of pregnancy complications in couples undergoing assisted reproduction treatment. The impact of HBV infection on the pregnancy outcomes of ART is still controversial. Current evidence does not support that ART increases the risk of vertical transmission of HBV, while relevant studies are limited. With the development of ART, the risk of HBV reactivation (HBVr) is increasing, especially due to the wide application of immunosuppressive therapy. CONCLUSIONS: Regular HBV infection screening and HBVr risk stratification and management are essential to prevent HBVr during ART. The determination of optimal strategy and timing of prophylactic anti-HBV therapy during ART still needs further investigation.
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Affiliation(s)
- Lingjian Zhang
- Department of Infectious Diseases, Affiliated Hangzhou First People's Hospital, School of Medicine, Zhejiang University, Hangzhou 310003, China
| | - Fangfang Zhang
- Women's Hospital, School of Medicine, Zhejiang University, Hangzhou 310003, China
| | - Zhiyuan Ma
- Key Laboratory of Clinical Cancer Pharmacology and Toxicology Research of Zhejiang Province, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China.
| | - Jie Jin
- Department of Infectious Diseases, Affiliated Hangzhou First People's Hospital, School of Medicine, Zhejiang University, Hangzhou 310003, China.
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Guo Y, Dong Y, Zheng R, Yan J, Li W, Xu Y, Yan X, Ke Y, Li Y, Xiang L. Correlation between viral infections in male semen and infertility: a literature review. Virol J 2024; 21:167. [PMID: 39080728 PMCID: PMC11290048 DOI: 10.1186/s12985-024-02431-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2024] [Accepted: 07/06/2024] [Indexed: 08/02/2024] Open
Abstract
Infertility affects approximately one-sixth of couples globally, with the incidence of male infertility steadily increasing. However, our understanding of the impact of viral infections on fertility remains limited. This review consolidates findings from previous studies, outlining 40 viruses identified in human semen and summarizing their key characteristics, modes of transmission, and their effects on both the reproductive and endocrine systems. Furthermore, it elucidates potential pathogenic mechanisms and treatment prospects of viruses strongly associated with male infertility. This synthesis will enhance our comprehension of how viral infections influence male reproductive health, offering valuable insights for future research as well as the diagnosis and treatment of infectious infertility.
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Affiliation(s)
- Yan Guo
- Department of Reproductive Gynecology, NHC Key Laboratory of Healthy Birth and Birth Defect Prevention in Western China, the First People's Hospital of Yunnan Province, Kunming, Yunnan, China
- The Affiliated Hospital of Kunming University of Science and Technology, Kunming, Yunnan, China
- Faculty of Life Science and Technology, Kunming University of Science and Technology, Kunming, Yunnan, China
| | - Yunhua Dong
- Department of Reproductive Medicine, NHC Key Laboratory of Healthy Birth and Birth Defect Prevention in Western China, the First People's Hospital of Yunnan Province, Kunming, Yunnan, China
- KUST-YPFPH Reproductive Medicine Joint Research Center, Medical school of Kunming University of Science and Technology, Kunming, Yunnan, China
- The Affiliated Hospital of Kunming University of Science and Technology, Kunming, Yunnan, China
| | - Runzi Zheng
- Department of Reproductive Medicine, NHC Key Laboratory of Healthy Birth and Birth Defect Prevention in Western China, the First People's Hospital of Yunnan Province, Kunming, Yunnan, China
- KUST-YPFPH Reproductive Medicine Joint Research Center, Medical school of Kunming University of Science and Technology, Kunming, Yunnan, China
- The Affiliated Hospital of Kunming University of Science and Technology, Kunming, Yunnan, China
- Faculty of Life Science and Technology, Kunming University of Science and Technology, Kunming, Yunnan, China
| | - Jiacong Yan
- Department of Reproductive Medicine, NHC Key Laboratory of Healthy Birth and Birth Defect Prevention in Western China, the First People's Hospital of Yunnan Province, Kunming, Yunnan, China
- KUST-YPFPH Reproductive Medicine Joint Research Center, Medical school of Kunming University of Science and Technology, Kunming, Yunnan, China
- The Affiliated Hospital of Kunming University of Science and Technology, Kunming, Yunnan, China
| | - Weiyuan Li
- Department of Reproductive Medicine, NHC Key Laboratory of Healthy Birth and Birth Defect Prevention in Western China, the First People's Hospital of Yunnan Province, Kunming, Yunnan, China
- KUST-YPFPH Reproductive Medicine Joint Research Center, Medical school of Kunming University of Science and Technology, Kunming, Yunnan, China
- The Affiliated Hospital of Kunming University of Science and Technology, Kunming, Yunnan, China
| | - Ya Xu
- Department of Clinical Laboratory, the First People's Hospital of Yunnan Province, Kunming, Yunnan, China
| | - Xuelan Yan
- Department of Reproductive Gynecology, NHC Key Laboratory of Healthy Birth and Birth Defect Prevention in Western China, the First People's Hospital of Yunnan Province, Kunming, Yunnan, China
- The Affiliated Hospital of Kunming University of Science and Technology, Kunming, Yunnan, China
| | - Yunmei Ke
- Department of Reproductive Gynecology, NHC Key Laboratory of Healthy Birth and Birth Defect Prevention in Western China, the First People's Hospital of Yunnan Province, Kunming, Yunnan, China
- The Affiliated Hospital of Kunming University of Science and Technology, Kunming, Yunnan, China
| | - Yantao Li
- Department of Reproductive Gynecology, NHC Key Laboratory of Healthy Birth and Birth Defect Prevention in Western China, the First People's Hospital of Yunnan Province, Kunming, Yunnan, China
- The Affiliated Hospital of Kunming University of Science and Technology, Kunming, Yunnan, China
| | - Lifeng Xiang
- Department of Reproductive Medicine, NHC Key Laboratory of Healthy Birth and Birth Defect Prevention in Western China, the First People's Hospital of Yunnan Province, Kunming, Yunnan, China.
- KUST-YPFPH Reproductive Medicine Joint Research Center, Medical school of Kunming University of Science and Technology, Kunming, Yunnan, China.
- The Affiliated Hospital of Kunming University of Science and Technology, Kunming, Yunnan, China.
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Wang Z, Liu W, Zhang M, Wang M, Wu H, Lu M. Effect of Hepatitis B Virus Infection on Sperm Quality and Outcomes of Assisted Reproductive Techniques in Infertile Males. Front Med (Lausanne) 2021; 8:744350. [PMID: 34796185 PMCID: PMC8592897 DOI: 10.3389/fmed.2021.744350] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Accepted: 10/11/2021] [Indexed: 01/21/2023] Open
Abstract
Background: Hepatitis B virus (HBV) infection is one of the health problems and has adverse effects on public health. However, the consequences of male HBV carriers for assisted reproductive techniques (ART) remain unclear. Objective: To examine whether men with HBV would impact sperm quality and the intrauterine insemination (IUI)/ in vitro fertilization (IVF)/ intracytoplasmic sperm injection (ICSI) outcomes. Methods: We retrospectively analyzed data from 681 infertile couples for IUI/IVF/ICSI fresh cycle outcomes. Case group was 176 infertile couples with male HBV infection undergoing embryo transfer in our center (99 for IVF and 77 for ICSI) and 51 infertile couples for IUI. Negative control was 454 non-infected infertility couples, matched for female age, BMI and infertility duration (102 for IUI and 198 for IVF and 154 for ICSI). Results: Sperm viability among infertile men with HBV infection was significantly lower than control group (74.1 ± 13.7 vs. 77.0 ± 12.8, P < 0.01). Sperm motility was significantly decreased in HBV positive men in comparison to the control group (32.5 ± 14.6 vs. 35.5 ± 12.9, P < 0.05). In IVF/ICSI cycles, two groups had similar results in two pronuclear (2PN) fertilization rate, implantation rate, clinical pregnant rate and abortion rate (P > 0.05). There was also no difference in the clinical pregnant rate and abortion rate in IUI cycles (P > 0.05). Conclusion: Men with HBV infection will affect their sperm quality, but not affect the outcomes of ART.
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Affiliation(s)
- Zichun Wang
- Department of Reproductive, The First Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Wanpeng Liu
- Department of Reproductive, The First Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Mingming Zhang
- Department of Reproductive, The First Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Minglei Wang
- Department of Reproductive, The First Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Huaying Wu
- Department of Reproductive, The First Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Meisong Lu
- Department of Reproductive, The First Affiliated Hospital of Harbin Medical University, Harbin, China
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Alhamoud AH, Matary F, Bukhari S, Kelantan M, Bajahzer M. Outcomes of an In Vitro Fertilization Pregnancy With COVID-19 and the Perinatal Outcome in Riyadh, Saudi Arabia. Cureus 2020; 12:e12296. [PMID: 33510990 PMCID: PMC7831387 DOI: 10.7759/cureus.12296] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Coronavirus disease 2019 (COVID-19) caused by the novel severe respiratory syndrome coronavirus 2 (SARS-CoV-2) is a pandemic and potentially fatal disease. COVID-19 cases are on the rise globally; this also includes risk groups such as pregnant women and neonates. Herein, we report the first COVID-19 cesarean delivery case of an in vitro fertilization (IVF) pregnancy in a Saudi woman. A postdate pregnant healthy woman tested positive with COVID-19 on her 38 weeks + five days. On her 40 weeks + five days, the woman had dilation without contractions; thereby, cesarean delivery was decided. The delivery was successful, with no complications in the mother and neonate. The preferable outcomes of this case could be attributable to some factors: multidisciplinary medical management, the mother’s young age, and COVID-19 infection during the late trimester.
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Affiliation(s)
- Abdullah H Alhamoud
- Medicine, College of Medicine, King Saud Bin Abdulaziz University for Health Sciences College of Medicine, Riyadh, SAU.,Laboratory Medicine, Al-Imam Abdulrahman Al-Faisal Hospital, Ministry of Health, Riyadh, SAU
| | - Faeza Matary
- Obstetrics and Gynaecology, Al-Imam Abdulrahman Al-Faisal Hospital, Ministry of Health, Riyadh, SAU
| | - Shaheera Bukhari
- Obstetrics and Gynaecology, Al-Imam Abdulrahman Al-Faisal Hospital, Ministry of Health, Riyadh, SAU
| | - Mashael Kelantan
- Medicine, School of Population and Global Health, The University of Melbourne, Melbourne, AUS.,Public Health, Ministry of Education, Riyadh, SAU
| | - Mohammed Bajahzer
- Clinical Nutrition, Applied Medical Sciences, Jazan University, Jazan, SAU
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Tenofovir and telbivudine combination therapy rapidly decreases viral loads in immune-tolerant chronic hepatitis B patients awaiting assisted reproduction: an open-label, randomized, controlled study. Eur J Gastroenterol Hepatol 2019; 31:832-835. [PMID: 30601336 DOI: 10.1097/meg.0000000000001345] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Immune-tolerant chronic hepatitis B (CHB) patients awaiting assisted reproduction (AR) are required to initiate antiviral therapy because of laboratory safety concerns. The antiviral therapy in this group has not been well assessed. We sought to explore the efficacy and safety of the combination therapy (COM) of tenofovir (TDF) and telbivudine (LdT). PATIENTS AND METHODS In this open-label, randomized, controlled study, we enrolled and randomized hepatitis B virus e-antigen (HBeAg)-positive CHB patients awaiting AR into the study COM group and the control (TDF) group. The COM group received combination therapy of TDF and LdT, and the TDF group received a single treatment of TDF. The patients were followed up for at least 48 weeks. The primary endpoint was the proportion of patients with undetectable HBV DNA level at week 12. RESULTS A total of 121 patients were recruited into the COM group (n=60) and the TDF group (n=61). The percentages of patients with undetectable HBV DNA levels were 90.0% (54/60) in the COM group and 67.2% (41/61) (P=0.002) in the TDF group at week 12; the percentages were 96.6% (58/60) in the COM group and 85.2% (52/61) in the TDF group at week 48 (P=0.028), respectively. HBeAg seroconversion occurred in 5/60 (8.3%) patients in the COM group and 2/61 (3.3%) patients in the TDF group at week 48 (P=0.233). CONCLUSION TDF and LdT combination therapy shows a rapid antivirological response in immune-tolerant CHB patients awaiting AR, which provide an alternative for this group at AR centers. However, the HBeAg seroconversion rate is unsatisfactory in the short term.
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Nie R, Wang M, Liao T, Qian K, Zhu G, Jin L. Assisted conception does not increase the risk for mother-to-child transmission of hepatitis B virus, compared with natural conception: a prospective cohort study. Fertil Steril 2019; 111:348-356. [PMID: 30691633 DOI: 10.1016/j.fertnstert.2018.10.021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2018] [Revised: 10/20/2018] [Accepted: 10/22/2018] [Indexed: 01/16/2023]
Abstract
OBJECTIVE To determine whether assisted conception increases the risk for mother-to-child transmission of hepatitis B virus (HBV) infection compared with natural conception. DESIGN Prospective cohort study. SETTING Research laboratory. PATIENT(S) A total of 305 children, 176 born with assisted conception and 129 born with natural conception, were born to a total of 251 hepatitis B surface antigen- (HBsAg-) positive women. INTERVENTION(S) None. MAIN OUTCOME MEASURE(S) The seropositive rates of HBsAg in children at birth and HBV infection rates at 9-15 months of age. RESULT(S) Overall, 7.5% (23/305) of children were HBsAg-positive at birth. The rate of HBsAg-positive children at birth did not significantly differ between children in the assisted conception group compared with those in the natural conception group (6.3% [11/176] vs. 9.3% [12/129]). Multivariate logistic regression analysis showed that conception method is not related to the rate of HBsAg-positive children at birth. All children who were positive for HBsAg at birth and were followed up for 9-15 months became negative for HBsAg after hepatitis B immunization. CONCLUSION(S) Assisted conception does not increase the risk for mother-to-child transmission of HBV compared with natural conception.
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Affiliation(s)
- Rui Nie
- Reproductive Medicine Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China
| | - Mingyue Wang
- Reproductive Medicine Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China
| | - Tantan Liao
- Reproductive Medicine Center, Affiliated Hospital of Guangdong Medical University, Guangdong Medical University, Zhanjiang, People's Republic of China
| | - Kun Qian
- Reproductive Medicine Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China
| | - Guijin Zhu
- Reproductive Medicine Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China
| | - Lei Jin
- Reproductive Medicine Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China.
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HBs Ag and HCV Status Need to Be Specified Before Using Assisted Reproductive Technique. HEPATITIS MONTHLY 2017. [DOI: 10.5812/hepatmon.65297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/13/2023]
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Lao TT, Mak JSM, Li TC. Hepatitis B virus infection status and infertility causes in couples seeking fertility treatment-Indicator of impaired immune response? Am J Reprod Immunol 2017; 77. [PMID: 28120470 DOI: 10.1111/aji.12636] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2016] [Accepted: 01/04/2017] [Indexed: 12/31/2022] Open
Abstract
PROBLEM The relationship between hepatitis B (HBV) infection in infertile couples seeking in vitro fertilization (IVF) treatment and infertility causes is unknown. METHODS OF STUDY A total of 831 infertile couples attending our unit seeking IVF during January to December 2015 were recruited. RESULTS HBV infection was found in 6.3% and 7.3% of female and male partners, respectively, and infection in one or both partners was associated with less primary infertility (44.2% vs 55.1%, P=.038). Infected female partners had increased tubal (69.2% vs 43.2%, P<.001) and uterine (13.7% vs 3.1%, P<.001) causes and reduced idiopathic infertility, while infected male partners were associated with increased tubal (62.3% vs 43.4%, P=.004) causes and reduced endometriosis (62.3% vs 73.9%, P=.050). CONCLUSION Our results suggest HBV infection in either partner was associated with tubal infertility. HBV infection in either partner probably increases the risk of pelvic infection in female partner through impaired immune response to sexually transmitted infections, with consequent tubal damage and infertility.
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Affiliation(s)
- Terence T Lao
- Departments of Obstetrics & Gynaecology, The Chinese University of Hong Kong, Hong Kong, China.,Prince of Wales Hospital, Hong Kong, China
| | - Jennifer S M Mak
- Departments of Obstetrics & Gynaecology, The Chinese University of Hong Kong, Hong Kong, China.,Prince of Wales Hospital, Hong Kong, China
| | - Tin-Chiu Li
- Departments of Obstetrics & Gynaecology, The Chinese University of Hong Kong, Hong Kong, China.,Prince of Wales Hospital, Hong Kong, China
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11
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Jin L, Nie R, Li Y, Xiao N, Zhu L, Zhu G. Hepatitis B surface antigen in oocytes and embryos may not result in vertical transmission to offspring of hepatitis B virus carriers. Fertil Steril 2015; 105:1010-3. [PMID: 26730499 DOI: 10.1016/j.fertnstert.2015.12.008] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2015] [Revised: 12/02/2015] [Accepted: 12/03/2015] [Indexed: 01/14/2023]
Abstract
OBJECTIVE To investigate the vertical transmission of hepatitis B virus (HBV) via embryos to children and whether HBV in embryos has an effect on the development of the fetus and pregnancy outcomes of in vitro fertilization and embryo transfer (IVF-ET). DESIGN Long-term follow-up study. SETTING Research laboratory. PATIENT(S) Thirty-one couples with a hepatitis B surface antigen (HBsAg)-negative woman and HBsAg-positive man, and 41 couples with a HBsAg-positive woman and HBsAg-negative man, whose unfertilized oocytes and nonviable embryos were tested for HBV DNA, RNA, or HBsAg. INTERVENTION(S) HBV DNA, RNA, or HBsAg analyses in unfertilized oocytes and nonviable embryos. MAIN OUTCOME MEASURE(S) HBV serologic markers analyses. RESULT(S) We obtained follow-up data for 71 couples. A total of 24 babies were born, and no newborns exhibited defects at birth. Twelve babies were born to couples with HBV-positive oocytes and/or embryos. The pregnancy outcomes were not associated with the presence of HBV in oocytes and embryos. Three patterns of HBV serologic markers were screened. Twenty babies were anti-HBs-positive. Three babies were negative for HBsAg, antibody to hepatitis B surface antigen (anti-HBs), antibody to hepatitis B core antigen (anti-HBc), HBeAg, and antibody to hepatitis B e antigen (anti-HBe). One baby was seropositive for anti-HBs, anti-HBc, and anti-HBe at 6 months of age but seroconverted from anti-HBe-positive to anti-HBe-negative at 9 months of age. CONCLUSION(S) The presence of HBsAg in oocytes and embryos may not result in the vertical transmission of HBV in the offspring of HBV carriers.
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Affiliation(s)
- Lei Jin
- Reproductive Medicine Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China
| | - Rui Nie
- Reproductive Medicine Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China.
| | - Yufeng Li
- Reproductive Medicine Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China
| | - Nan Xiao
- Reproductive Medicine Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China
| | - Lixia Zhu
- Reproductive Medicine Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China
| | - Guijin Zhu
- Reproductive Medicine Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China
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12
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Nelson NP, Jamieson DJ, Murphy TV. Prevention of Perinatal Hepatitis B Virus Transmission. J Pediatric Infect Dis Soc 2014; 3 Suppl 1:S7-S12. [PMID: 25232477 PMCID: PMC4164184 DOI: 10.1093/jpids/piu064] [Citation(s) in RCA: 77] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Hepatitis B virus (HBV) infection, the most common form of chronic hepatitis worldwide, is a major public health problem affecting an estimated 360 million people globally. Mother-to-child transmission (MTCT) is responsible for more than one third of chronic HBV infections worldwide. An estimated 15%-40% of persons chronically infected develop HBV-related complications, such as cirrhosis and hepatic carcinoma, and 25% die from these complications. MTCT can occur during pregnancy or during delivery. Screening pregnant women for HBV infection, providing infant postexposure prophylaxis, and maternal treatment with antiviral medications are strategies for reducing MTCT transmission rates and the global burden of new chronic HBV infections. Administration of hepatitis B immune globulin (HBIG) and hepatitis B (HepB) vaccine within 24 hours of birth, followed by completion of the vaccine series, is 85%-95% efficacious for prevention of MTCT. Despite timely post-exposure prophylaxis, MTCT occurs in 5%-15% of infants. Hepatitis B surface antigen (HBsAg) positive, hepatitis e antigen (HBeAg) positive mothers with HBV DNA level ≥10(6) copies/mL (>200 000 IU/mL) are at greatest risk of transmitting HBV to their infants. Consensus recommendations and evidence-based guidelines for management of chronic HBV infection and screening of pregnant women have been developed. The safety and efficacy of antiviral drug use during pregnancy are areas of ongoing research. Substantial advances have been achieved globally in reducing MTCT, but MTCT remains an ongoing health problem. Attaining a better understanding of the mechanisms of MTCT, implementing existing policies on maternal screening and infant follow-up, and addressing research gaps are critical for further reductions in MTCT transmission.
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Affiliation(s)
- Noele P. Nelson
- Division of Viral Hepatitis, Vaccine Research and Policy Unit, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention
| | - Denise J. Jamieson
- Women's Health and Fertility Branch, Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Trudy V. Murphy
- Division of Viral Hepatitis, Vaccine Research and Policy Unit, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention
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13
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Shi L, Liu S, Zhao W, Zhou H, Ren W, Shi J. Hepatitis B virus infection reduces fertilization ability during in vitro fertilization and embryo transfer. J Med Virol 2014; 86:1099-104. [PMID: 24760595 DOI: 10.1002/jmv.23908] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/27/2014] [Indexed: 01/22/2023]
Abstract
Whether hepatitis B virus (HBV) infection impairs human infertility is unclear. The present retrospective case-controlled study investigated the impact of HBV on sperm parameters, ovarian stimulation, and outcomes of in vitro fertilization (IVF) and embryo transfer. A total of 224 couples with at least one partner being HBsAg-seropositive undergoing their first IVF and embryo transfer cycle were identified, which included 77 couples with female partners being HBsAg-seropositive, 136 couples with male partners being HBsAg-seropositive, and 11 couples with both partners being HBsAg-seropositive. A total of 448 both HBsAg-seronegative couples served as controls. The percentage of normal sperm morphology was significantly lower in HBsAg-seropositive male partners than that in HBsAg-seronegative male partners (11.9 ± 9.4% vs. 19.0 ± 11.9%, P < 0.01). The duration of infertility was significantly prolonged in HBV-seropositive patients compared with HBV-seronegative patients (4.9 vs. 4.1 years, P < 0.01). Couples with female partners being HBsAg-seropositive had significantly lower top-quality embryo rate than control group (22.4% vs. 31.6%, P < 0.01). In addition, the fertilization rates in groups with male or female partners being HBsAg-seropositive were both significantly lower than the matched controls (80.2% vs. 82.8%, P < 0.05; 76.6% vs. 84.3%, P < 0.01, respectively). HBV infection was also found to be associated negatively with fertilization rate by logistic regression analysis (odds ratios: 0.410, 95% confidence interval: 0.186-0.906, P < 0.05). However, there was no significant difference in clinical pregnancy rates between HBsAg-seropositive and HBsAg-seronegative group. These results suggest that chronic HBV infection is likely to represent a significant cause of infertility.
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Affiliation(s)
- Lin Shi
- Department of Immunology and Microbiology, Xi'an Jiaotong University College of Medicine, Xi'an, China
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14
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Garolla A, Pizzol D, Bertoldo A, Menegazzo M, Barzon L, Foresta C. Sperm viral infection and male infertility: focus on HBV, HCV, HIV, HPV, HSV, HCMV, and AAV. J Reprod Immunol 2013; 100:20-9. [DOI: 10.1016/j.jri.2013.03.004] [Citation(s) in RCA: 73] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2012] [Revised: 03/20/2013] [Accepted: 03/20/2013] [Indexed: 12/09/2022]
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15
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Endo Y, Fujii Y, Shintani K, Seo M, Motoyama H, Funahashi H. Simple vitrification for small numbers of human spermatozoa. Reprod Biomed Online 2011; 24:301-7. [PMID: 22285239 DOI: 10.1016/j.rbmo.2011.11.016] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2011] [Revised: 11/19/2011] [Accepted: 11/23/2011] [Indexed: 11/18/2022]
Abstract
Conventional freezing procedures and containers are not appropriate for spermatozoa from the testis because of their low number and poor in-situ motility, and various types of container have been utilized to freeze small numbers of spermatozoa. This study tried to develop a vitrification method for small numbers of spermatozoa using the Cell Sleeper, which is a closed type of cell-cryopreservation container. The container with spermatozoa were cooled in liquid nitrogen vapour and then stored in a cryotank. Sperm motility parameters improved significantly (P < 0.05) by vitrification in oil-free droplets rather than in droplets covered with oil. After vitrification of five spermatozoa per container, all spermatozoa were recovered and the viable sperm rate was significantly higher when spermatozoa were vitrified in a 3.5-ll droplet rather than in 0.5 ll (72.0% versus 38.0%; P < 0.01). Recovery, motility and viability rates of vitrified–warmed spermatozoa were similar between the Cell Sleeper and the CryoTop groups. In conclusion, the Cell Sleeper is a highly effective tool for the cryopreservation of small numbers of spermatozoa and limited cells can be vitrified quickly and simply without significant loss.
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Affiliation(s)
- Yuji Endo
- IVF Center, Kurashiki Medical Clinic, 250-1, Bakurocho, Kurashiki 710-8522, Japan.
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16
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Zhou XP, Hu XL, Zhu YM, Qu F, Sun SJ, Qian YL. Comparison of semen quality and outcome of assisted reproductive techniques in Chinese men with and without hepatitis B. Asian J Androl 2011; 13:465-9. [PMID: 21399651 DOI: 10.1038/aja.2010.164] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
In this study, we aimed to determine the effects of hepatitis B virus (HBV) infection on sperm quality and the outcome of assisted reproductive technology (ART). A total of 916 men (457 HBV-positive and 459 HBV-negative) seeking fertility assistance from January 2008 to December 2009 at the Women's Hospital in the School of Medicine at Zhejiang University were analysed for semen parameters. Couples in which the men were hepatitis B surface antigen (HBsAg)-seropositive were categorized as HBV-positive and included 587 in vitro fertilisation (IVF) and 325 intracytoplasmic sperm injection (ICSI) cycles from January 2004 to December 2009; negative controls were matched for female age, date of ova retrieval, ART approach used (IVF or ICSI) and randomized in a ratio of 1:1 according to the ART treatment cycles (587 for IVF and 325 for ICSI). HBV-infected men exhibited lower semen volume, lower total sperm count as well as poor sperm motility and morphology (P < 0.05) when compared to control individuals. Rates of two-pronuclear (2PN) fertilisation, high-grade embryo acquisition, implantation and clinical pregnancy were also lower among HBV-positive patients compared to those of HBV-negative patients after ICSI and embryo transfer (P < 0.05); IVF outcomes were similar between the two groups (P > 0.05). Logistic regression analysis showed that HBV infection independently contributed to increased rates of asthenozoospermia and oligozoospermia/azoospermia (P < 0.05) as well as decreased rates of implantation and clinical pregnancy in ICSI cycles (P < 0.05). Our results suggest that HBV infection in men is associated with poor sperm quality and worse ICSI and embryo transfer outcomes but does not affect the outcome of IVF and embryo transfer.
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Affiliation(s)
- Xu-Ping Zhou
- Key Laboratory of Women's Reproductive Health of Zhejiang Province, Hangzhou 310006, China
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Nie R, Jin L, Zhang H, Xu B, Chen W, Zhu G. Presence of hepatitis B virus in oocytes and embryos: a risk of hepatitis B virus transmission during in vitro fertilization. Fertil Steril 2011; 95:1667-71. [PMID: 21269614 DOI: 10.1016/j.fertnstert.2010.12.043] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2010] [Revised: 12/15/2010] [Accepted: 12/16/2010] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To define the risk of hepatitis B virus (HBV) transmission through oocytes and embryos from chronic HBV carriers. DESIGN Laboratory-based study. SETTING Research laboratory in a university hospital. PATIENT(S) Thirty-one couples with hepatitis B surface antigen (HBsAg)-negative women and HBsAg-positive men, 41 couples with HBsAg-positive women and HBsAg-negative men, and 39 seronegative couples. INTERVENTION(S) None. MAIN OUTCOME MEASURE(S) Hepatitis B virus DNA and RNA analyses in oocytes and embryos, and the location of virus particles containing HBsAgs. RESULT(S) Hepatitis B virus DNA was detected in 3 of 18 male HBsAg-positive/female HBsAg-negative couples (and in 13 of 84 embryos) and 3 of 14 male HBsAg-negative/female HBsAg-positive couples (and in 15 of 71 oocytes and embryos). Hepatitis B virus RNA was detected in 9 of 13 male HBsAg-positive/female HBsAg-negative couples (and in 39 of 52 embryos) and 8 of 17 male HBsAg-negative/female HBsAg-positive couples (and in 30 of 63 oocytes and embryos). The HBsAg, which is present in the nuclei and cytoplasm of oocytes and embryos, was detected in 6 of 10 male HBsAg-negative/female HBsAg-positive couples (and in 13 of 20 oocytes and embryos). Hepatitis B virus DNA, HBV RNA, and HBsAg were not found in 135 oocytes and embryos from 39 seronegative couples. CONCLUSION(S) The presence of HBV in oocytes and embryos suggests the possibility of vertical transmission of HBV via the germ line.
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Affiliation(s)
- Rui Nie
- Reproductive Medicine Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China
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