Li Yutao, Wang Xuejiao, Jiang Ye, Lv Qun, Zhang Yi, Wang Yu
Department of Assisted Reproduction Center, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, Sichuan, 610041, China.
Department of Assisted Reproduction Center, Sichuan Jinxin Xinan Women and Children's Hospital, Chengdu, Sichuan, 610041, China.
BMC Med. 2025 Feb 4;23(1):58. doi: 10.1186/s12916-025-03905-6.
This study assessed the impact of chronic hepatitis B virus (HBV) infection on ovarian reserve in women.
We analyzed data from 38,861 infertile women undergoing their first in vitro fertilization (IVF) treatment (2016-2022), including 1574 HBsAg-positive cases. A control group of 1574 HBsAg-negative women was matched by age and body mass index (BMI). Comparison of clinical characteristics, antral follicle count (AFC), follicle-stimulating hormone (FSH), luteinizing hormone (LH)/FSH ratio, anti-Müllerian hormone (AMH), gonadotropins (Gn) days, total Gn dosage, number of retrieved oocytes, number of mature metaphase II (MII) oocytes, and the proportion of patients with diminished ovarian reserve (DOR; AMH < 1.1 ng/ml) between two groups.
HBsAg-positive women showed lower basal AFC and AMH, higher basal FSH, received more Gn, and had fewer retrieved and MII oocytes than HBsAg-negative women. No significant differences in ovarian reserve or stimulation outcomes were found between e antigen-positive and e antigen-negative HBV-infected groups. DOR was less prevalent in HBsAg-negative women, and logistic regression indicated a higher DOR risk with HBV infection.
HBsAg positivity significantly impairs ovarian reserve in women, but e antigen status does not notably affect it among HBV-infected individuals.
本研究评估了慢性乙型肝炎病毒（HBV）感染对女性卵巢储备功能的影响。
我们分析了38861名接受首次体外受精（IVF）治疗（2016 - 2022年）的不孕女性的数据，其中包括1574例HBsAg阳性病例。选取1574例HBsAg阴性女性作为对照组，按照年龄和体重指数（BMI）进行匹配。比较两组患者的临床特征、窦卵泡计数（AFC）、促卵泡生成素（FSH）、黄体生成素（LH）/FSH比值、抗苗勒管激素（AMH）、促性腺激素（Gn）使用天数、总Gn用量、获卵数、成熟MII期卵母细胞数以及卵巢储备功能减退（DOR；AMH < 1.1 ng/ml）患者的比例。
与HBsAg阴性女性相比，HBsAg阳性女性的基础AFC和AMH较低，基础FSH较高，使用的Gn更多，获卵数和MII期卵母细胞数更少。在e抗原阳性和e抗原阴性的HBV感染组之间，卵巢储备功能或促排卵结局未发现显著差异。DOR在HBsAg阴性女性中更为少见，逻辑回归分析表明HBV感染会增加DOR的风险。
HBsAg阳性显著损害女性的卵巢储备功能，但在HBV感染者中，e抗原状态对其影响不明显。
