ICSI outcome in women who have positive PCR result for hepatitis C virus.

BACKGROUND

Hepatitis C virus (HCV) carriers are often accepted into the assisted reproduction technique programme of fertility centres. Studies showed that HCV RNA was detected in the follicular fluid of HCV PCR positive females. The objective of this study was to assess the impact of HCV active on the outcome of ICSI.

METHODS

This study was conducted on 40 women who proved to be positive for HCV, using RT-PCR. Two control groups (both n = 40), who were negative for HCV by PCR were also included. The first control group was HCV sero-positive and the second was HCV sero-negative. We compared the three groups regarding the ovarian response to stimulation, embryo quality and pregnancy rates.

RESULTS

The number of failed cycles (lack of ovarian response to stimulation) was higher in HCV RT-PCR positive and sero-positive females than sero-negative controls (P = 0.0001). There were no differences in embryo cleavage or morphology between the study and control groups. The pregnancy rate was significantly reduced in the HCV-PCR-positive group compared with the PCR negative/HCV sero-positive and HCV sero-negative control groups (5, 3 and 48%, respectively; P = 0.001). There was a negative correlation between number of oocytes and viral load (0.419; P = 0.007).

CONCLUSIONS

Our results suggest that HCV infection in females undergoing ICSI has a negative impact on the outcome, and the impact is higher in PCR positive cases: this might be attributed to hormonal disturbance associated with viral liver cirrhosis coinciding with active viral replication.