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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 investigate whether men receiving IVF / ICSI during and after hepatitis B virus infection have an effect on pregnancy outcome. Methods: A retrospective analysis of 496 pairs of infertile couples who were treated with IVF / ICSI for the first time was performed. Serum HBV and 5 hepatitis B were detected preoperatively. Five of the women with hepatitis B were negative or only HbsAb positive and HBV-DNA negative. According to the results of male hepatitis B, the patients were divided into 3 groups: group A (297 couples): 5 male patients with hepatitis B were negative or only HbsAb positive and HBV-DNA negative; group B (81 couples) DNA positive; C group (118 couples): male hepatitis B three positive and negative for HBV-DNA. Statistical analysis of the first three fresh cycle treatment and pregnancy outcomes, and further comparison of three groups of ICSI cycle clinical outcomes. Results: The clinical pregnancy rates of women in groups A, B and C (40.1% vs 47.9% vs 36.7%) and early miscarriage rates (8.3% vs 8.6% vs 2.5%) were not significantly different in IVF / ICSI cycles. The rates of returning to babies (34.2% vs 42.5% vs 33.9%) and infant birth rates were also similar in all groups. In the ICSI cycle, there was no significant difference in clinical pregnancy rate, early miscarriage rate, rate of arrival of babies and infant birth (P> 0.05). CONCLUSIONS: Male fertilized with either IVF or ICSI during HBV infection and convalescence had no adverse effect on pregnancy outcomes and infant birth.