Different Miscarriage Rate and Birthweights After In Vitro Fertilization versus Intracytoplasmic Sperm Injection Embryo Transfer in Couples With Male Hepatitis B Virus Infection: A Retrospective Study.

BACKGROUND

The influence of paternal Hepatitis B virus infection on reproductive outcomes after in vitro fertilization or intracytoplasmic sperm injection is still debated. While differences in sperm-oocyte interaction duration and intensity between in vitro fertilization and intracytoplasmic sperm injection may lead to divergent viral exposure effects. Nevertheless, research specifically examining these differences remains limited.

OBJECTIVES

To evaluate how various insemination techniques influence the effects of paternal Hepatitis B virus infection on reproductive outcomes in couples during in vitro fertilization/intracytoplasmic sperm injection treatments.

MATERIAL AND

METHODS

This retrospective study analyzed 37,088 initial frozen-thawed embryo transfer cycles among women without Hepatitis B virus infection from February 2007 to August 2023. Patients were grouped into two categories based on paternal Hepatitis B virus surface antigen status: paternal Hepatitis B virus surface antigen positive (Hepatitis B virus surface antigen [+]) and negative (Hepatitis B virus surface antigen [-]) categories. Further stratified analyses were performed according to the insemination method. The primary endpoints were measures of pregnancy and neonatal results. An analysis using logistic regression was conducted to explore the independent link between paternal Hepatitis B virus infection and the specified outcomes.

RESULTS

In in vitro fertilization-derived embryos, paternal Hepatitis B virus infection was significantly associated with an elevated risk of miscarriage (adjusted odds ratio 1.55, 95% confidence interval 1.22-1.96), small for gestational age (adjusted odds ratio 1.70, 95% confidence interval 1.12-2.59), and very small for gestational age (adjusted odds ratio 3.07, 95% confidence interval 1.64-5.76) by comparison with controls. No such associations occurred with intracytoplasmic sperm injection-derived embryos.

DISCUSSION: Prior studies have shown inconsistent findings on the effects of paternal Hepatitis B virus infection on these outcomes. This study provides evidence that paternal infection with the Hepatitis B virus independently elevates the risks of miscarriage, small for gestational age, and very small for gestational age births following in in vitro fertilization, but not intracytoplasmic sperm injection. This discrepancy might be due to differences in the extent and duration of oocyte exposure to the Hepatitis B virus.

CONCLUSIONS

Male Hepatitis B virus infection independently increases the risk of miscarriages and the birth of small for gestational age and very small for gestational age infants after in vitro fertilization embryo transfer, but not after intracytoplasmic sperm injection.