MATERNAL hepatitis B virus infection does not appear to reduce the likelihood of pregnancy or live birth following in vitro fertilisation or intracytoplasmic sperm injection, according to new research. However, the study identified a higher rate of preterm birth among women with hepatitis B.
Researchers retrospectively analysed 3,455 first-time fresh IVF or ICSI embryo-transfer cycles performed at a reproductive medicine centre in China between 2018 and 2020.
The cohort included 811 cycles involving women with maternal hepatitis B virus infection and 2,644 cycles in which neither partner had hepatitis B surface antigen. Propensity-score matching was used to account for differences in baseline characteristics, producing 810 closely matched pairs.
The analysis considered outcomes across the reproductive pathway, including oocyte maturation, fertilisation, embryo development, implantation, pregnancy, delivery and neonatal health.
Following matching, maternal hepatitis B infection was not associated with significant differences in oocyte maturation, normal fertilisation, high-quality embryo development or blastocyst formation.
Clinical pregnancy rates were comparable between the hepatitis B and control groups, at 44.44% and 45.43%, respectively. Live-birth rates were also similar, at 32.59% among women with hepatitis B and 32.96% among controls.
No significant differences were found in implantation, miscarriage, stillbirth or ectopic-pregnancy rates. Rates of gestational hypertension, gestational diabetes, premature rupture of membranes and caesarean delivery were also comparable.
Preterm birth was the principal outcome that differed between groups. After matching, 15.73% of births in the hepatitis B group were preterm, compared with 7.78% in the control group.
The researchers noted that the reason for this association remains uncertain. Chronic inflammation, immune changes and effects on placental development represent possible explanations, but detailed information on viral load, antiviral treatment and liver function was unavailable.
The retrospective, single-centre design also means the findings cannot establish that hepatitis B directly causes preterm birth.
Nevertheless, the results offer reassurance that maternal hepatitis B infection may not substantially compromise the probability of IVF or ICSI success. The elevated preterm-birth rate warrants confirmation in prospective studies and may support closer obstetric monitoring of affected pregnancies.
Jiang W et al. The impact of maternal hepatitis B virus infection on IVF/ICSI-assisted pregnancy outcomes: a propensity score-matched cohort study. Front Med. 2026;13:1925066.
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