The Vertical Transmission Risk In The Patients With HBV In IVF And The Relation Of Ration Of Serum Estradiol And The Ration Of Progesterone-Estradiol Ration On IVF-ET Pregnancy Rate In COH

Part one Set exploring the Vertical transmission risk in the patien ts with hepatitis B virus in vitro fertilization.BACKGROUND:Hepatitis B virus(HBV) infection is a serious public health problem worldwide,it can cause severe chronic communicable disease.The incidence of this disease is very high in our China.Now,with the delay of the pregnancy age of women and the high incidence of infertility,more and more patients who infected HBV want to obtain the treatment of assisted reproductive techniques.It is essential to evaluate the risk of HBV vertical transmission in these patients undergoing in-vitro-fertilization and embryo transfer(IVF-ET).With the development of Assistance reproduction technique,IVF-ET has become the important method for treating infertility patient.nowadays,the clinic pregnancy rate has raised remarkably,but the majority cycle has not succeed.many factors can affect the pregnancy rate.such as patients's age,embyro quality,the receptivity of endometrium and the variance of hormonal concentration incriminated hyperstimulation ovulation,etal.among these factors,there is always dispute about the relation of the variance of hormonal concentration and IVF-ET pregnancy rate.This research is composed of two parts:1 Set exploring the Vertical transmission risk in the patients with HBV in vitro fertilization.2.the relation of serum ration of Estradiol and the ration of progesterone-Estradiol Ration on IVF-ET pregnancy rate in controlled ovarian hyperstimulation Cycle. Part oneOBJECTIVE:To study the transmission risk of hepatitis B virus in HBV infected patients during the in-vitro-fertilization and embryo transfer procedure.MATERIALS AND METHODS:149 female HBV(Hepatitis B Virus) infected patients and 144 male HBV infected patients undergoing ovarian stimulation and in-vitro-fertilization and embryo transfer (IVF-ET) was analyzed between May.2007 and March.2008.Serologic testing of HBV infection(HBsAg,HBsAb,HBeAg,anti-HBe, anti-HBc-IgG) of blood,follicle fluid/sperm and fertilization culture medium/post-washing sperm in female/male infected patients were detected by enzyme linked immunosorbent assay(ELISA) on the day of oocytes/sperm collection.RESULTS:1.In 18 female patients who are seropositive for HBsAg,HBeAg,and anti-HBc-IgG,the same antigen and antibody can be detected in all 18 follicle-fluid and fertilization culture medium(100%,100%);In 131 female patients who are seropositive for HBsAg,anti-HBe,anti-HBc-IgG,the same antigen and antibody can be detected in 84 follicle-fluid(64.1%),and 8 fertilization culture medium(6.1%).If the patients' follicle-fluid is negative for all the markers,their fertilization culture medium remain negative.2.In 23 male patients who are seropositive for HBsAg,HBeAg,and anti-HBc-IgG,the same antigen and antibody can be detected in only 6 sperm(26.1%),all the post-washing sperm were exhibited negative;In 121 male patients who are seropositive for HBsAg,anti-HBe, anti-HBc-IgG,the same antigen and antibody can be detected in only 7 sperm(5.8%),and all the post-washing sperm were negative. CONCLUSION:In IVF-ET procedures,the risk of HBV vertical transmission is higer in those female patients who showed seropositive for HBsAg,HBeAg,and anti-HBc-IgG than those who showed seropositive for HBsAg,anti-HBe,anti-HBc-IgG.The risk of HBV vertical transmission is no change in those female patients who showed seropositive for HBsAg,HBeAg,and anti-HBc-IgG in IVF-ET procedure. The risk of HBV vertical transmission may be lower in both the HBsAg, anti-HBe,anti-HBc-IgG positive female patients and in the male patients with HBV.Part twoOBJECTIVE:To study the relation of serum ration of Estradiol and the ration of progesterone- Estradiol Ration on IVF-ET pregnancy rate in controlled ovarian hyperstimulation Cycle.METHODS:in 695 infertility patients who underwent IVF-ET,serum estradiol levels were measured on the day of HCG administration,one day before ET and the day+7 after ET,serum progesterone levels were measured on the day+7 after ET.RESULTS:The ration of E2 level on hCG day to that of one day before ET was not correlated to pregnancy rate.The ration of E2 on hCG day to that on the day +7 after ET was inversely correlated to pregnancy rate.The pregnancy rate was significantly lower with higher ratio.The ration of P/E2 on the day +7 after ET was inversely negative correlated to pregnancy rate with significant differences.CONCLUSION:The ration of E2 on hCG day to that on the day +7 after ET,the ratio of P/E2 on the day +7 after ET are valuable for predicting IVF outcome.