Impact of hepatitis B virus infection on IVF/ICSI-assisted pregnancy outcomes in women: a propensity score-matched cohort study

Abstract Objective To explore the impact of hepatitis B virus infection on In Vitro Fertilization/ Intracytoplasmic Sperm Injection (IVF/ ICSI)-assisted pregnancy outcomes in women. Methods A retrospective cohort study design was used. A retrospective analysis was performed on the clinical data of 3455 cycles of infertile couples who underwent fresh embryo transfer with IVF/ICSI-ET assisted pregnancy for the first time in the Reproductive Center of Fujian Maternal and Child Health Hospital from January 2018 to December 2020, and the male did not carry HBV virus. Patients were divided into HBV group (n=811) and non-HBV group (n=2644) based on whether the women carried HBV virus or not. Propensity score matching method (PSM) was used to perform 1:1 matching for the HBV group to the non-HBV group with relatively balanced covariates, and the final HBV and non-HBV groups were both 805 cycles. The baseline levels of the two matched groups were consistent, and the laboratory and clinical outcomes of IVF/ICSI assisted pregnancy were compared between the two groups. Results Baseline levels such as male age, female age, body mass index, basal follicle-stimulating hormone (FSH), basal luteinizing hormone (LH), basal estrogen (E2), anti-Mullerian hormone (AMH), basal antral follicle count, years of infertility, types of infertility, causes of infertility, ovulation induction regimen, the duration of gonadotropin (Gn), Gn dose, E2 level on HCG day, progesterone level on HCG day, endometrial thickness on HCG day, method of insemination(IVF/ICSI), number of transferred embryos and type of transferred embryos were relatively consistent in the two groups after PSM, with no significant differences (P > 0.05). There were no statistically significant differences in egg maturation rate (52.89% vs 53.47%), high-quality embryo rate (57.76% vs 58.51%), blastocyst formation rate (63.48% vs 63.56%) and clinical pregnancy rate (44.47% vs 44.84%), live birth rate (32.92% vs 34.91%), perinatal complications and birth fetal weight between the two groups (P > 0.05 ). However, the preterm birth rate was significantly higher in the HBV-infected group compared to the non-HBV group, with a statistically significant difference between the two groups (15.85% vs. 9.96%, P=0.04). Conclusion HBV infection in women increased the risk of preterm delivery in IVF/ICSI-assisted pregnancy, but pregnancy and live birth rates were comparable to those of non-HBV-infected patients and were not significantly associated with poor obstetric and neonatal outcomes.