Hepatitis B infection and outcomes of in vitro fertilization and embryo transfer treatment

Lam, Paul; Suen, Sik Hung; Lao, Terence T.; Cheung, Lai Ping; Leung, Tak Yeung; Haines, Christopher J.

doi:10.1016/j.fertnstert.2009.01.137

Cited by 57 publications

(57 citation statements)

References 13 publications

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“…This would have explained why foetal growth was enhanced in untreated women with HBV infection. Another possible contributing factor is immunologic adaptations following chronic HBV infection that facilitated placental implantation and perfusion from reduced rejection of the foetal allograft, as shown by the improved pregnancy rate found in HBsAg positive women undergoing IVF treatment [44]. Indeed, a subtle immune adaptation is probably present in pregnant women with positive HBsAg in view of the association between HBsAg carriage and rubella nonimmunity [37].…”

Section: Discussionmentioning

confidence: 99%

Maternal HBsAg status and infant size – a Faustian bargain?

Lao

Sahota

Suen

et al. 2012

Journal of Viral Hepatitis

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Information on the impact of maternal hepatitis B virus (HBV) infection on pregnancy outcome is conflicting. Some studies reported an association with increased infant birthweight, which could be interpreted as advantageous to pregnancy. A retrospective study was performed to compare birthweight outcome between 6261 and 55,817 singleton pregnancies in mothers screened positive and negative for hepatitis B surface antigen (HBsAg), respectively. The HBsAg positive women were younger, had higher body mass index (BMI) and incidence of overweight, but less gestational weight gain, and were associated with increased macrosomia (birthweight ≥4000 g) in mothers <35 years (odds ratio, OR, 1.28), BMI ≥25 kg/m(2) (OR 1.24), without gestational diabetes mellitus (GDM, OR 1.19), and in male infants (OR 1.18). It was also associated with increased large-for-gestational age (LGA, birthweight >90th percentile) infants in nulliparas (OR 1.13), age <35 years (OR 1.12), BMI ≥25 kg/m(2) (OR 1.19), with (OR 1.36) and without (OR 1.09) GDM, and in male infants (OR 1.13). When the effects of high BMI, advanced age, GDM, and male infants were controlled for, positive HBsAg was significantly associated with macrosomic (adjusted odds ratio, aOR, 1.15) and LGA (aOR 1.11) infants. In view of the latest findings on the association between high infant birthweight with increased risk of obesity, diabetes mellitus, and various forms of malignancies from childhood to adulthood, further studies are warranted to determine if maternal hepatitis B infection would impact adversely on the long-term health of the offspring through its effect on increasing birthweight.

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Section: Discussionmentioning

confidence: 99%

Maternal HBsAg status and infant size – a Faustian bargain?

Lao

Sahota

Suen

et al. 2012

Journal of Viral Hepatitis

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“…10 Interestingly, another study comparing HBV-seropositive couples (n534) with age-matched female controls showed higher implantation and pregnancy rates in HBV-positive individuals. 11 These discrepancies may be due in part to differences in the matched control groups used for comparison as well as differences in overall sample size. In contrast to previous studies, we specifically matched controls according to the ART approach used, female age Hepatitis B virus and male reproductive performance XP Zhou et al 468 (61 year) and oocyte retrieval period.…”

Section: Discussionmentioning

confidence: 99%

“…Pirwany et al 10 observed lower implantation and pregnancy rates in HBV-positive individuals (10 couples with HBVpositive men and 3 couples with HBV-positive women) compared to a healthy control group. In contrast, Lam et al 11 reported higher implantation and pregnancy rates in the HBV-seropositive group compared to those in the HBV-seronegative group.…”

Section: Introductionmentioning

confidence: 85%

Comparison of semen quality and outcome of assisted reproductive techniques in Chinese men with and without hepatitis B

Zhou¹,

Hu²,

Zhu³

et al. 2011

Asian J Androl

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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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“…Although being responsible for cirrhosis and hepatocellular carcinoma (HCC), HBV is a non-cytopathic virus which can enjoy peaceful co-existence in hepatocytes unless the immune system begins to mount an immune response against infected hepatocytes. As HCC rarely occurs before the age of 40 years 33 and its highest agespecific rates is at ≥60 years in the high-risk African population and ≥75 years in high-risk Asian populations, 34 this outcome was immaterial before the twentieth century when life expectancy was less than 60 years of age even in the more affluent western countries. 35 Furthermore, HCC is not an inevitable outcome of HBV infection, as its occurrence is also influenced by gene-environmental interactions and is less common among females.…”

Section: Discussionmentioning

confidence: 99%