Assisted reproduction in hepatitis carrier couples

Area of Science:

• Hepatology
• Reproductive Medicine
• Virology

Background:

• Chronic Hepatitis B virus (HBV) infection is a global health concern, particularly in Asia-Pacific regions.
• Limited and conflicting literature exists on HBV's impact on subfertility and assisted reproductive technology (ART) outcomes.
• Recent findings suggest HBV presence in ovarian tissues, posing a potential vertical transmission risk.

Purpose of the Study:

• To review the current literature on the effects of chronic HBV infection on female fertility and ART outcomes.
• To investigate the presence and replication of HBV in female reproductive tissues during in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) cycles.
• To evaluate the implications of HBV viral replication for vertical transmission and consider the role of antiviral therapy.

Main Methods:

• Systematic literature review on HBV infection and fertility outcomes.
• Analysis of recent observational data on HBV carriers undergoing IVF/ICSI.
• Detection of HBV DNA in ovarian tissue, follicular fluid, and oocytes.

Main Results:

• Current evidence does not indicate a detrimental effect of chronic HBV infection on IVF/ICSI success rates in women.
• HBV has been detected in ovarian tissue, including oocytes and follicular fluid.
• Evidence of HBV viral replication was observed in female HBV carriers during IVF/ICSI treatment cycles.

Conclusions:

• Chronic HBV infection does not appear to negatively affect IVF/ICSI treatment outcomes.
• The presence and replication of HBV in ovarian tissue present a risk for vertical transmission, even with immunoprophylaxis.
• The administration of antiviral medication during ovarian stimulation in IVF/ICSI cycles for chronic HBV carriers warrants consideration to mitigate vertical transmission risk.