| Objective:To study the effect of in vitro fertilization-embryo transfer(IVF-ET)on pregnancy outcomes and neonatal outcomes after HBV infection by both partners or one partner at different HBV DNA copy Numbers.Methods:1.Methods From January 2015 to December 2017,a total of 558 couples with hepatitis B in one side or both sides who were treated with IVF/ICSI in the Department of Reproductive Medicine of the second affiliated Hospital of Kunming Medical University were selected.According to the different infection patterns,the subjects were divided into 3 different research groups.Study Group 1:single man infection group;a total of 325 cases;Study Group 2:Single woman infection Group,a total of 206 cases;Study Group 3:two sides infection group,a total of 27 cases.According to the number of copies of HBV DNA,the Study Group 1 and 2 were divided into different subsets.If HBV DNA?5.0×102,it is a high copy group,and if HBV DNA<5.0×102,it is a low copy group.Among them,there were 44 cases in the high copy group of the Study Group 1,281 cases in the low copy group,27 cases in the high copy group of the Study Group 2,and 179 cases in the low copy group,27 cases in the Study Group 3.As a result of the small number of cases included,no patients were found to have HBV DNA?5.0×102,so the study Group 3 was not re-grouped.At the same time,510 cases of serum HBsAg negative in both husband and wife were randomly selected as normal negative control,that is,control group.A retrospective analysis of the above data is carried out.2.In this study,Spss 25.0 software package was used for date processing,the data of six groups were retrospectively analyzed,and six groups of infertile couples were counted for differences in mature egg rate,fertilization rate,cleavage rate,high-quality embryo rate,clinical pregnancy rate,early process rate,live birth rate,preterm birth rate,neonatal weight and number of single and double births.At the same time,the HBV infection of the offspring was followed up.Results:1.General conditions of the six groups,such as the woman's age,body mass index,infertility years,infertility causes(including primary and secondary),and differences in basic FSH level and AMH level were not statistically significant(P>0.05).There was no significant difference in the choice of ovulation promotion scheme,fertilization method,Gn days,Gn and dosage among the six groups(P>0.05).There was no significant difference in the rate of mature eggs and cleavage between the six groups(P>0.05).However,the fertilized rate of the six groups was not the same,Results The fertilization rates were 61.13±22.01,51.53 ±14.96,63.00±22.46,5.33±20.15,50.33±22.48,65.19±22.22respectively.The fertilization rate of high copy group(61.13±22.01)and low copy group(51.53 ± 14.96)of study group 1 was lower than that of control group(65.19±22.22,P<0.05).The fertilization rate of low copy group was higher than that of high copy group(P<0.05).The high quality embryo rates were 49.83±30.28,45.97 ±26.58,41.50 ±26.70,39.48±25.17,43.06±32.75,50.85±29.63,respectively.The rate of high quality embryos in the two subgroups of the study group was lower than that of the control group.The high-quality embryo rate of low copy group of study group 2 was higher than that of high copy group of the same study group,and the difference was statistically significant(P<0.05).There was no significant difference in live birth rate,early abortion rate,premature birth rate,newborn weight and number of single twins among the three groups(P>0.05).The clinical pregnancy rates were 34.9%,24.39%,21.25%,12%,15.38%,42.5%,respectively(P<0.05).The difference was also statistically significant(P<0.05).The pregnancy rate of each study group was lower than that of the control group,and the difference was also statistically significant(P<0.05).The clinical pregnancy rate of the low copy group of study group 2 was lower than that of the low copy group of study group 1.2.A total of 145 offspring were born out of 113 births in study groups 1,2,and 3.Among the 73 cases that were followed up,40 cases were not examined or lost to follow-up due to serology,among which only one case was infected.The infected person appeared in study group 3,with a total infection rate of 1.4%.Conclusions:1.The fertilization rate decreases in the process of IVF/ICSI pregnancy in men with HBV infection alone,and the decrease of fertilization rate is more obvious when HBV DNA is in high copy.2.A simple woman is infected with HBV,which reduces the rate of high quality embryos,and the rate of fertilization decreases more significantly when HBV DNA is in high copy;3.Regardless of the mode of HBV infection,will lead to a decrease in clinical pregnancy rate,but in the same number of viral copies of the woman infected with a lower rate of clinical pregnancy;4.Both husband and wife are infected with HBV and have lower rates of fertilization and clinical pregnancy than those infected with only one single side;the infection rate of offspring of 5.HBV infected persons is 1.4%,The risk of infection in the offspring may not be increased during the implementation of IVF/ICSI pregnancy. |
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