Outcomes of Assisted Reproductive Technology in Women With Hepatitis B Infection

Hepatitis B virus (HBV) infection remains a global public health problem. To investigate whether HBV infection in women with different serostatus affects the outcomes of assisted reproductive technology (ART). This study included a total of 9891 infertile couples, comprising 1670 couples with HBV-infected women and 8221 couples without HBV infection, all undergoing ART treatments during the same period. None of the male partners had chronic HBV infection. Three groups were defined: HBV-positive, HBeAg/preS1-positive and HBV-negative groups. Pregnancy outcomes were evaluated and compared using multivariate logistic regression analysis to control for confounding factors. Decreased rates of implantation, clinical pregnancy and live birth were observed in women with HBeAg/preS1-seropositive status. Following multivariate adjustment for potential confounders, the live birth and clinical pregnancy rates in the HBeAg/preS1-positive group were still significantly lower than those in the HBV-negative group, with adjusted odds ratios of 0.86 (95% CI, 0.75–0.99) and 0.84 (95% CI, 0.73–0.96), respectively. No significant difference was observed between the HBV-positive and HBV-negative groups. Additionally, no differences were found in the miscarriage rate or preterm rate among the three groups. Women who were HBsAg- or HBeAg/preS1-seropositive exhibited a significantly higher incidence of secondary and tubal factor infertility compared to those without HBV infection. Overall HBV infection in women increases the risk of secondary infertility and tubal factor infertility, and female HBeAg/preS1-seropositive status adversely affects live birth and clinical pregnancy outcomes. The effect is likely attributed to the active HBV infection.