母体HBsAg携带状态对IVF-ET结局的影响:基于倾向性评分匹配的回顾性队列研究OA

Objectives:To investigate the impact of maternal hepatitis B surface antigen(HBsAg)carrier status on the clinical pregnancy outcomes of the treatment cycles with in vitro fertilization/intracytoplasmic sperm injection(IVF/ICSI). Methods:A retrospective cohort study was conducted to analyze the clinical data of 4 033 women undergoing their first IVF/ICSI treatment between June 2012 and December 2024.Based on maternal HBsAg carrier status,patients were divided into a HBsAg-positive group and a HBsAg-negative group.Propensity score matching(PSM)was utilized to match patients at a 1∶2 ratio(HBsAg-positive group,n=461;HBsAg-negative group,n=922).Baseline characteristics were compared between the two groups after matching.Controlled ovarian stimulation outcomes and pregnancy outcomes were compared between the groups for both IVF and ICSI cycles independently.Multivariate logistic regression models were used to analyze independent factors for pregnancy success. Results:There were no significant differences in baseline characteristics such as age,duration of infertility,type of infertility,and body mass index(BMI)between the two groups(P＞0.05).However,levels of alanine aminotransferase(ALT)and aspartate aminotransferase(AST)were significantly higher in the HBsAg-positive group than those of the HBsAg-negative group(P＜0.05).In terms of ovarian stimulation and pregnancy outcomes,there were no significant differences in the number of retrieved oocytes,number of high-quality embryos,cycle transfer rate and clinical pregnancy rate between the two groups in either IVF or ICSI cycles(P＞0.05).Multivariate logistic regression analysis indicated that HBsAg positive status had no significant effect on the clinical pregnancy rate in either IVF or ICSI cycles.However,female age and the total number of retrieved oocytes were independent factors for the clinical pregnancy rate(P＜0.05). Conclusions:Maternal HBsAg carrier status has no significant direct impact on the cycle transfer rate or clinical pregnancy rate in IVF or ICSI cycles.Patients' age and ovarian responsiveness(such as the number of oocytes retrieved)remain the key factors for IVF/ICSI outcomes.