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母体慢性乙型肝炎病毒感染不会影响接受首次体外受精治疗的不孕患者的妊娠结局。

Maternal chronic hepatitis B virus infection does not affect pregnancy outcomes in infertile patients receiving first in vitro fertilization treatment.

机构信息

Shenzhen Key Laboratory of Reproductive Immunology for Peri-implantation, Shenzhen Zhongshan Institute for Reproduction and Genetics, Shenzhen Zhongshan Urology Hospital, Shenzhen, Guangdong, People's Republic of China.

Shenzhen Key Laboratory of Reproductive Immunology for Peri-implantation, Shenzhen Zhongshan Institute for Reproduction and Genetics, Shenzhen Zhongshan Urology Hospital, Shenzhen, Guangdong, People's Republic of China; Laboratory of Molecular Pharmacology, Department of Pharmacology, School of Pharmacy, Southwest Medical University, Luzhou, People's Republic of China.

出版信息

Fertil Steril. 2019 Aug;112(2):250-257.e1. doi: 10.1016/j.fertnstert.2019.03.039. Epub 2019 May 15.

DOI:10.1016/j.fertnstert.2019.03.039
PMID:31103286
Abstract

OBJECTIVE

To evaluate whether maternal chronic hepatitis B virus (HBV) infection affects pregnancy outcomes in infertile patients undergoing their first in vitro fertilization (IVF) treatment.

DESIGN

A retrospective case control study.

SETTING

Fertility center.

PATIENT(S): Female patients, comprising 8,550 infertile women including 180 HBsAgHBeAg, 714 HBsAgHBeAg, and 7,656 HBsAg seronegative controls undergoing their first IVF treatments.

INTERVENTION(S): Clinical characteristics, pregnancy and neonatal outcomes were analyzed by Kruskal-Wallis test, analysis of variance, or chi-square test. Logistic regression was employed to verify the contribution of maternal HBV to clinical pregnancy, live birth, and miscarriage.

MAIN OUTCOME MEASURE(S): Primary outcome: live-birth rate; secondary outcomes: implantation, clinical pregnancy, and miscarriage rates.

RESULT(S): An increased duration of infertility and more secondary infertility and ovulatory disorders were observed in the HBV patients. The implantation rate was statistically significantly lower in the HBsAgHBeAg group compared with the controls. However, the clinical pregnancy rate, miscarriage rate, live-birth rate, neonatal outcomes, and pregnancy complications showed no statistically significant differences among the groups. The logistic regression analysis showed that HBV infection status did not affect the clinical pregnancy, miscarriage, or live-birth rates, unlike maternal age, endometrial thickness, and use of high-quality embryos.

CONCLUSION(S): Hepatitis B virus infection is not an independent contributor to pregnancy outcomes, although it is associated with prolonged infertility duration, a high frequency of secondary infertility and ovulatory disorders, and a reduced implantation rate.

摘要

目的

评估母体慢性乙型肝炎病毒(HBV)感染是否会影响接受首次体外受精(IVF)治疗的不孕患者的妊娠结局。

设计

回顾性病例对照研究。

地点

生育中心。

患者

女性患者,包括 8550 名不孕妇女,其中 180 名 HBsAgHBeAg、714 名 HBsAgHBeAg 和 7656 名 HBsAg 阴性对照患者,均接受首次 IVF 治疗。

干预措施

通过 Kruskal-Wallis 检验、方差分析或卡方检验分析临床特征、妊娠和新生儿结局。采用 logistic 回归检验母体 HBV 对临床妊娠、活产和流产的影响。

主要观察指标

主要结局:活产率;次要结局:着床率、临床妊娠率和流产率。

结果

HBV 患者的不孕时间延长,继发性不孕和排卵障碍更为常见。与对照组相比,HBsAgHBeAg 组的着床率显著降低。然而,各组的临床妊娠率、流产率、活产率、新生儿结局和妊娠并发症无统计学差异。logistic 回归分析显示,HBV 感染状况并不影响临床妊娠、流产或活产率,而母体年龄、子宫内膜厚度和使用优质胚胎则有影响。

结论

尽管 HBV 感染与不孕时间延长、继发性不孕和排卵障碍发生率高以及着床率降低有关,但它不是妊娠结局的独立影响因素。

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