[A nested case-control study on the impact of hepatitis B virus infection in men on in vitro fertilization/intracytoplasmic sperm injection outcomes].

Objective

To study the effect of hepatitis B virus (HBV) infection in men on the outcome of in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI) treatments, and to explore the factors influencing different outcomes of IVF/ICSI.

Methods

This was a nested case-control study, in which clinical data were collected from 3 560 couples who underwent IVF/ICSI treatment in the Department of Reproductive Medicine of the First Affiliated Hospital of Xiamen University between June 2012 and December 2024, of whom 496 were male HBsAg-positive (including 77 HBeAg-positive and 419 HBeAg-negative). Semen parameters between the groups were analyzed for their association with the differences in treatment outcomes. Factors affecting reproductive outcomes of IVF/ICSI were assessed using the multifactorial logistic regression analysis.

Results

HBsAg-positivity in males did not significantly affect reproductive outcomes such as IVF/ICSI implantation rates and pregnancy rates. Semen pH was lower in the HBeAg-positive group, and the proportion of non-progressive motile sperm in semen was higher in the HBeAg-positive group. Additionally, liver function indicators (e.g., alanine aminotransferase, azelaic aminotransferase) were significantly higher in the HBsAg-positive group than in the control group. Multifactorial analysis showed that the transplantation outcomes of IVF/ICSI were influenced by factors such as female age and the proportion of non-forward-moving spermatozoa in the semen. The clinical pregnancy outcomes of IVF were influenced by semen density and the total number of eggs obtained, and those of ICSI were influenced by the female age and the time of semen liquefaction.

Conclusions

In this study, we did not find any significant effect of HBV infection in men on the reproductive outcome of IVF/ICSI. However, HBV infection affects semen motility and liver function, and female age, semen motility, semen density, and liquefaction time are the key influences on the different outcomes of IVF/ICSI.