不孕夫妇非活动性乙型肝炎病毒表面抗原携带对体外受精-胚胎移植的影响  

Effect on undergoing in vitro fertilization and embryo transfer treatment of subfertile couples carrying inactive hepatitis B virus surface antigen

作　　者：梁毓[1] 辛志敏 兰永连[1] 李颖[1] 王树玉[1] Liang Yu;Xin Zhimin;Lan Yonglian;Li Ying;Wang Shuyu(Human Reproductive Medicine Department,Beijing Obstetrics and Gynecology Hospital,Capital Medical University,Beijing 100026,China)

机构地区：[1]首都医科大学附属北京妇产医院生殖医学科,北京100026

出　　处：《中华实验和临床感染病杂志（电子版）》2021年第3期171-176,共6页Chinese Journal of Experimental and Clinical Infectious Diseases(Electronic Edition)

基　　金：北京市属医院科研培育项目(No.PX2021054)。

摘　　要：目的探讨乙型肝炎病毒(HBV)感染与不孕症的关系,以及HBV表面抗原(HBsAg携带对体外受精(IVF)和胞浆内单精子注射(ICSI)治疗结局的影响。方法对2018年1月至2019年12月于首都医科大学附属北京妇产医院行IVF治疗的398对不孕夫妇进行回顾性分析,其中HBsAg阳性组共71对夫妇(其中女方阳性组32例,男方阳性组39例);夫妻双方HBsAg均阴性为对照组(327对夫妇)。比较两组女性年龄、不孕年限、体重指数、基础卵泡刺激素(FSH)水平、窦卵泡数、抗缪勒管激素(AMH)、促性腺激素(Gn)总量、内膜厚度、获卵数、不孕原因、不孕类型、受精率、优质胚胎率、种植率、妊娠率等。呈正态分布的计量资料(年龄、体重指数、基础FSH水平、Gn天数、内膜厚度)比较采用独立样本t检验,呈偏态分布的计量资料(不孕年限、窦卵泡数、AMH、Gn总量、获卵数)比较采用Wilcoxon秩和检验;计数资料比较采用Pearson卡方检验(不孕类型、受精率、优质胚胎率、种植率、妊娠率、流产率)或Fisher确切概率法检验(不孕原因)。结果两组女性年龄(t=1.95、P=0.05)、不孕年限(Z=-0.8、P=0.43)、不孕原因(χ^(2)=4.06、P=0.40)、体重指数(t=0.68、P=0.50)、基础FSH水平(t=-0.29、P=0.97)、窦卵泡数(Z=-0.80、P=0.42)以及AMH(Z=-1.45、P=0.15)等差异均无统计学意义。两组女性促排方案(χ^(2)=2.83、P=0.24)、促排天数(t=1.64、P=0.10)、Gn总量(Z=-1.77、P=0.08)、内膜厚度(t=-0.08、P=0.94)、获卵数(Z=-0.93、P=0.35)、IVF受精率(χ^(2)=2.44、P=0.12)、ICSI受精率(χ^(2)=1.02、P=0.91)及优胚率(χ^(2)=3.62、P=0.06)差异均无统计学意义。在新鲜胚胎移植周期,HBsAg阳性组和对照组分别移植45个和213个周期,两组种植率(χ^(2)=0.00、P=1.0)、临床妊娠率(χ^(2)=0.47、P=0.50)及流产率(χ^(2)=0.11、P=0.75)差异均无统计学意义。结论非活动性HBsAg携带对不孕症和IVF/ICSI助孕结局未见明显影响。Objective To investigate the relationship between hepatitis B virus(HBV)infection and infertility,and to evaluate the impact of inactive HBV surface antigen(HBsAg)carriers on in vitro fertilization(IVF)/intracytoplasmic sperm injection(ICSI)outcomes for infertile patients.Methods Total of 398 couples undergoing IVF in Beijing Obstetrics and Gynecology Hospital,Capital Medical University from January 2018 to December 2019 were recruited;Among them,71 couples were HBV seropositive(including female positive group with 32 cases and male positive group with 39 cases)and 327 couples were HBV seronegative controls.Age,duration of infertility,body mass index(BMI),basal follicle-stimulating hormone(bFSH),antral follicles count(AFC),anti-Müllerian hormone(AMH),total gonadotropin(Gn)dose,endometrial thickness,the number of oocytes,causes and types of infertility,fertilization rate,high-quality embryo rate,implantation and clinical pregnancy rates were compared between female of the two groups.Data of normal distribution(age,BMI,bFSH,Gn days,endometrial thickness)between the two groups were compared by independent sample t test,and data of skewed distribution(duration of infertility,AFC,AMH,total Gn dose,the number of oocytes)were compared by Wilcoxon rank sum test;the count data were analyzed by Pearson χ^(2) test (types of infertility, fertilization rate, high-quality embryo rate, implantation rate, pregnancy rate, miscarriage rate) or Fisher exact probability test (cause of infertility). Results Age (t = 1.95, P = 0.05), duration of infertility (Z =-0.8, P = 0.43), cause of infertility (χ^(2) = 4.06, P = 0.40), BMI (t = 0.68, P = 0.50), bFSH (t =-0.29, P = 0.97), AMH (Z =-1.45, P = 0.15) and AFC (Z =-0.80, P = 0.42) female between the two groups were without significant difference;In addition, the characteristics of IVF, including ovarian hyperstimulation regimen (χ^(2) = 2.83, P = 0.24), duration (t = 1.64, P = 0.10) and total dose of Gn (Z =-1.77, P = 0.08), endometrial thickness (t =-0.08, P = 0.94), number of oocy

关 键 词：肝炎病毒 乙型 体外受精-胚胎移植 

分 类 号：R714.8[医药卫生—妇产科学]