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Xu Y, Gan K, Hou L, Wang H, Cai J, Liu L, Wen W, Rao M, Tang L. The association between hepatitis B virus and semen quality: a systematic review and meta-analysis. BMC Urol 2024; 24:47. [PMID: 38389059 PMCID: PMC10885473 DOI: 10.1186/s12894-024-01424-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Accepted: 02/01/2024] [Indexed: 02/24/2024] Open
Abstract
BACKGROUND Some studies have suggested that hepatitis B virus (HBV) infection had a negative association with semen quality, but the conclusions have been inconsistent. The purpose of our study was to systematically assess the association between HBV infection and semen parameters. METHODS We searched electronic databases for studies published from January 1980 to August 2023. Eleven studies were included in the analysis. Primary outcomes were semen volume, sperm concentration, sperm morphology, sperm motility and sperm progressive motility. We also conducted a subgroup analysis between China and other countries. RESULT Compared with the semen quality of HBV-negative men, HBV infection had a negative association with semen volume (MD: -0.20 mL, 95%CI: -0.32 to - 0.09, P = 0.0004), sperm concentration (MD: -4.46 × 106/mL, 95%CI: -7.09 to - 1.84, P = 0.0009), sperm morphology (MD: -2.49%, 95%CI: -4.35 to - 0.64, P = 0.008), sperm motility (MD: -6.85%, 95%CI: -11.53 to - 2.18, P = 0.004), and sperm progressive motility (MD: -6.63%, 95%CI: -10.24 to - 3.02, P = 0.0003). However, HBV infection had no significant association with total sperm count (MD: -31.50 × 106, 95%CI: -74.11 to 11.10, P = 0.15). The association between HBV and semen quality were inconsistent between the subgroups. CONCLUSION HBV infection had a negative association with sperm concentration, motility, morphology, and semen volume. However, The association between HBV and total sperm count remain unclear. This metaanalysis suggests that we should pay attention to the adverse effect of HBV on sperm quality, and several studies have reported the relevant mechanisms. But due to the significant heterogeneity among studies on some semen parameters, further large and well-designed researches are needed before introducing clinical management recommendations.
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Affiliation(s)
- Yuting Xu
- Department of Reproductive genetics, Yan 'an Hospital Affiliated to Kunming Medical University, Kunming, 650051, China
| | - Kai Gan
- Department of Organ Transplantation, The First Affiliated Hospital of Kunming Medical University, Kunming, 650032, China
| | - Liqing Hou
- Department of Reproductive genetics, Yan 'an Hospital Affiliated to Kunming Medical University, Kunming, 650051, China
| | - Huawei Wang
- Department of Reproductive genetics, The First Affiliated Hospital of Kunming Medical University, 295 Xichang Road, Kunming, Yunnan Province, 650032, China
| | - June Cai
- Department of Reproductive genetics, Yan 'an Hospital Affiliated to Kunming Medical University, Kunming, 650051, China
| | - Liu Liu
- Department of Reproductive genetics, The First Affiliated Hospital of Kunming Medical University, 295 Xichang Road, Kunming, Yunnan Province, 650032, China
| | - Wen Wen
- Department of Reproductive genetics, The First Affiliated Hospital of Kunming Medical University, 295 Xichang Road, Kunming, Yunnan Province, 650032, China
| | - Meng Rao
- Department of Reproductive genetics, The First Affiliated Hospital of Kunming Medical University, 295 Xichang Road, Kunming, Yunnan Province, 650032, China.
| | - Li Tang
- Department of Reproductive genetics, The First Affiliated Hospital of Kunming Medical University, 295 Xichang Road, Kunming, Yunnan Province, 650032, China.
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Meng X, Dai X, Huang J, Han T, Liao X, Cheng K, Sun X, Xie Q, Sun P, Zhou X. The influence of male HBV infection on sperm quality, embryonic development, and assisted reproductive outcomes. Hum Reprod 2024; 39:43-52. [PMID: 37994690 DOI: 10.1093/humrep/dead235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 10/12/2023] [Indexed: 11/24/2023] Open
Abstract
STUDY QUESTION What is the impact of male hepatitis B virus (HBV) infection on sperm quality, embryonic development, and assisted reproductive outcomes? SUMMARY ANSWER Male HBV infection did not affect assisted reproductive outcomes, but HBV is capable of impairing human sperm and embryo formation in the early stages following fertilization. WHAT IS KNOWN ALREADY HBV is found in germ cells and early embryos of patients with HBV. HBV may impair human sperm function via increasing reactive oxygen species. STUDY DESIGN, SIZE, DURATION We conducted a retrospective cohort study of 1581 infertile couples, including 496 male patients clinically confirmed to have hepatitis B infection, and a laboratory study of effects of HBV proteins on early embryos, using human embryonic stem cells (hESCs), human sperm, and golden hamster oocytes. PARTICIPANTS/MATERIALS, SETTING, METHODS In total, 1581 infertile couples (24-40 years of age) who were admitted to a reproductive medicine center to undergo ART for the first time from January 2019 to November 2021 were selected as the study subjects. The case group was composed of 469 couples with hepatitis B surface antigen (HBsAg)-seropositive men and seronegative women (368 for IVF and 101 for ICSI treatment). The negative control group was composed of 1112 couples where both men and women were seronegative for hepatitis B antigen. We divided these couples into three comparison groups (IVF/ICSI, IVF, and ICSI). IVF of human sperm and hamster oocytes was used to evaluate the influence of the HBV HBs protein on formation of 2-cell embryos. Mitochondrial membrane potential (MMP) of hESCs was assayed via a fluorescence intensity system. Immunofluorescence staining of the phosphorylated histone H2A.X was applied to identify DNA damage to hESCs caused by the HBV X (HBx) protein. MAIN RESULTS AND THE ROLE OF CHANCE Sperm concentration, total sperm number, and sperm with normal morphology were decreased in the couples with HBV-infected males in couples who were undergoing IVF/ICSI (male HBV(+) vs control: 469 vs 1112 individuals; sperm number, P < 0.01; normal sperm morphology, P < 0.01), IVF (368 vs 792; sperm number, P < 0.01; normal sperm morphology, P ≤ 0.05), and ICSI (101 vs 306; sperm number, P < 0.01; normal sperm morphology, P < 0.001). There was no significant difference in the number of embryo cleavages, blastocyst formation, biochemical pregnancy rate, clinical pregnancy rate, and live-birth rate between case and control groups. The 2PN fertilization rate in IVF/ICSI (P < 0.01) and ICSI (P < 0.05) couples, and the number of 2PN-fertilized oocytes in IVF (P < 0.001) couples were lower in couples with male HBV infection compared to control couples. HBV HBs protein reduced the MMP of human sperm and decreased 2-cell embryo formation in IVF of human sperm and zona-free-hamster oocyte. A reduction in fluorescence intensity and immunofluorescence staining of phosphorylated histone H2A.X indicated that HBx caused MMP impairment and DNA damage in human early embryonic cells, respectively. LARGE SCALE DATA N/A. LIMITATIONS, REASONS FOR CAUTION HBV can be examined in samples of sperm or discarded IVF early embryos from HBsAg-seropositive men and seronegative women. The hESC model in vitro may not fully mimic the natural embryos in vivo. WIDER IMPLICATIONS OF THE FINDINGS This study furthers our understanding of the influence of male HBV infection on embryonic development. Our results suggest that a semen-washing process may be necessary for male patients with HBV undergoing ART to minimize the potential negative effects of HBV infection on the early embryo. STUDY FUNDING/COMPETING INTEREST(S) This work was funded by grants from the National Natural Science Foundation of China, grant numbers 81870432 and 81570567 to X.Z., 81571994 to P.S., and 81950410640, the Natural Science Foundation of Guangdong Province, China (No. 2023A1515010660 to X.Z.), and the Li Ka Shing Shantou University Foundation (Grant No. L11112008). The authors have no conflicts of interest.
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Affiliation(s)
- Xiangqian Meng
- Chengdu Xinan Gynecology Hospital; Sichuan Jinxin Xinan Women's & Children's Hospital (Bisheng), Chengdu, China
| | - Ximing Dai
- Stem Cell Research Center, Shantou University Medical College, Shantou, China
- Research Center for Reproductive Medicine, Shantou University Medical College, Shantou, China
- Guangdong Provincial Key Laboratory of Infectious Diseases and Molecular Immunopathology, Shantou University Medical College, Shantou, China
| | - Jihua Huang
- Chengdu Xinan Gynecology Hospital; Sichuan Jinxin Xinan Women's & Children's Hospital (Bisheng), Chengdu, China
| | - Tingting Han
- Chengdu Xinan Gynecology Hospital; Sichuan Jinxin Xinan Women's & Children's Hospital (Bisheng), Chengdu, China
| | - Xue Liao
- Chengdu Xinan Gynecology Hospital; Sichuan Jinxin Xinan Women's & Children's Hospital (Bisheng), Chengdu, China
| | - Ke Cheng
- Stem Cell Research Center, Shantou University Medical College, Shantou, China
- Research Center for Reproductive Medicine, Shantou University Medical College, Shantou, China
- Guangdong Provincial Key Laboratory of Infectious Diseases and Molecular Immunopathology, Shantou University Medical College, Shantou, China
| | - Xiaoyue Sun
- Stem Cell Research Center, Shantou University Medical College, Shantou, China
- Research Center for Reproductive Medicine, Shantou University Medical College, Shantou, China
- Guangdong Provincial Key Laboratory of Infectious Diseases and Molecular Immunopathology, Shantou University Medical College, Shantou, China
| | - Qingdong Xie
- Stem Cell Research Center, Shantou University Medical College, Shantou, China
- Research Center for Reproductive Medicine, Shantou University Medical College, Shantou, China
- Guangdong Provincial Key Laboratory of Infectious Diseases and Molecular Immunopathology, Shantou University Medical College, Shantou, China
| | - Pingnan Sun
- Stem Cell Research Center, Shantou University Medical College, Shantou, China
- Research Center for Reproductive Medicine, Shantou University Medical College, Shantou, China
- Guangdong Provincial Key Laboratory of Infectious Diseases and Molecular Immunopathology, Shantou University Medical College, Shantou, China
| | - Xiaoling Zhou
- Stem Cell Research Center, Shantou University Medical College, Shantou, China
- Research Center for Reproductive Medicine, Shantou University Medical College, Shantou, China
- Guangdong Provincial Key Laboratory of Infectious Diseases and Molecular Immunopathology, Shantou University Medical College, Shantou, China
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Ma NZ, Dai W, Bao X, Bu ZQ, Shi H, Sun YP. Effects of hepatitis B virus infection on the treatment outcomes following in vitro fertilization/intracytoplasmic sperm injection: An analysis of 21,999 first embryo transfer cycles. J Viral Hepat 2023; 30:889-896. [PMID: 37740608 DOI: 10.1111/jvh.13878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 07/18/2023] [Accepted: 07/20/2023] [Indexed: 09/24/2023]
Abstract
To investigate the effects of hepatitis B virus (HBV) infection on the outcomes of Chinese couples undergoing in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) and the clinical data of their neonates. A total of 21,999 first embryo transfer cycles were included. They were categorized into four groups based on the couple's hepatitis B surface antigen (HBsAg) result (Group A = female HBsAg- and male HBsAg- ; Group B = female HBsAg+ and male HBsAg- ; Group C = female HBsAg- and male HBsAg+ ; Group D = female HBsAg+ and male HBsAg+ ). The fertilization rate (FR), cleavage rate (CR), implantation rate (IPR), clinical pregnancy rate (CPR), live birth rate (LBR) and miscarriage rate (MCR) were analysed. Multilevel logistic regression was applied to evaluate the association. The total prevalence of HBV infection was 5.74% (2526/43998). There were no statistically significant differences in CRs (98.69%, 98.76%, 98.66%, 98.72%, p > .05), IPRs (45.86%, 47.33%, 45.19%, 39.61%, p > .05), CPRs (62.84%, 65.05%, 61.80%, 56.81%, p > .05), MCRs (12.70%, 11.99%, 12.58%, 4%, p > .05) and LBRs (53.43%, 55.38%, 52.70%, 54.54%, p > .05) among the four groups. However, there were significant differences in FRs (66.25%, 66.55%, 66.32%, 61.92%, p < .05). Group D had the lowest FR. After adjusting for confounders, the multilevel logistic regression showed that HBsAg+ had no impact on the LBR, CPR or MCR. We also analysed the data of 14,465 newborns, including 8593 singletons and 2936 twins. Among the four groups, no variables reached statistical significance, including neonatal birth weight (NBW), twin ratio, gestational age, premature birth, delivery type, fetal macrosomia or low birth weight (p > .05). Our study demonstrates that, although biparental HBV infection may affect the FR, neither single-parent infection nor biparental HBV infection affects IVF/ICSI outcomes or neonatal outcomes.
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Affiliation(s)
- Ning-Zhao Ma
- Department of Reproductive Medical Center, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Wei Dai
- Department of Reproductive Medical Center, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Xiao Bao
- Department of Reproductive Medical Center, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Zhi-Qin Bu
- Department of Reproductive Medical Center, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Hao Shi
- Department of Reproductive Medical Center, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Ying-Pu Sun
- Department of Reproductive Medical Center, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
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Xiong Y, Liu C, Wei W, Huang S, Wang J, Qi Y, Zou K, Tan J, Sun X. The impact of biparental hepatitis B virus infection on pregnancy outcomes in patients undergoing assisted reproductive technology treatment: a systematic review and meta-analysis. Arch Gynecol Obstet 2022; 306:1253-1266. [PMID: 35551455 DOI: 10.1007/s00404-022-06586-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Accepted: 04/15/2022] [Indexed: 02/08/2023]
Abstract
PURPOSE To evaluate the association between biparental hepatitis B virus (HBV) infection (hepatitis B surface antigen [HBsAg] seropositivity) and pregnancy outcomes in patients undergoing assisted reproductive technology (ART) treatment, including clinical pregnancy rate (CPR) and live birth rate (LBR). METHODS We searched various literature databases from the earliest date available until May 20, 2021, including PubMed, Embase, Medline, Web of Science, Scopus, CNKI, and Wangfang. Four patterns of biparental HBV infection for pregnancy outcomes following ART were synthesized separately by using random-effects model. We also performed subgroup analyses (matched or unmatched) and two forms of sensitivity analysis. RESULTS A total of 25 retrospective cohort studies, involving more than 19,269 couples, were included. Maternal and paternal HBV co-infection (crude relative risk [cRR]: 0.58, 95% confidence interval: 0.28-1.23), either maternal or paternal infection (cRR: 1.05, 0.88-1.24), maternal HBV infection alone (cRR: 0.96, 0.79-1.16), or paternal HBV infection alone (cRR: 1.02, 0.91-1.13) were not associated with significant reductions in CPR at per woman level. These patterns of infection were also not significantly associated with decreased LBR at per woman level. However, paternal HBV infection alone reduced CPR (adjusted odds ratio: 0.54, 0.33-0.86) and LBR (cRR: 0.52, 0.28-0.99) at per cycle level. Subgroup analyses and sensitivity analyses were mostly consistent with the primary results. CONCLUSIONS Paternal HBV infection alone probably decrease CPR after ART at per cycle level. However, maternal HBV infection was not associated with reductions in CPR and LBR in women undergoing ART at per woman level.
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Affiliation(s)
- Yiquan Xiong
- Chinese Evidence-Based Medicine Center, West China Hospital, Sichuan University, Chengdu, 610041, China.,NMPA Key Laboratory for Real World Data Research and Evaluation in Hainan, Chengdu, 610041, China
| | - Chunrong Liu
- Chinese Evidence-Based Medicine Center, West China Hospital, Sichuan University, Chengdu, 610041, China.,NMPA Key Laboratory for Real World Data Research and Evaluation in Hainan, Chengdu, 610041, China
| | - Wei Wei
- Department of First Convalescent, Dujiangyan Special Crew Sanatorium of PLA Air Force, Dujiangyan, 611830, China
| | - Shiyao Huang
- Sichuan Evidence-Based Medicine Center of Traditional Chinese Medicine, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, 610072, China
| | - Jing Wang
- Chinese Evidence-Based Medicine Center, West China Hospital, Sichuan University, Chengdu, 610041, China.,NMPA Key Laboratory for Real World Data Research and Evaluation in Hainan, Chengdu, 610041, China
| | - Yana Qi
- Chinese Evidence-Based Medicine Center, West China Hospital, Sichuan University, Chengdu, 610041, China.,NMPA Key Laboratory for Real World Data Research and Evaluation in Hainan, Chengdu, 610041, China
| | - Kang Zou
- Chinese Evidence-Based Medicine Center, West China Hospital, Sichuan University, Chengdu, 610041, China.,NMPA Key Laboratory for Real World Data Research and Evaluation in Hainan, Chengdu, 610041, China
| | - Jing Tan
- Chinese Evidence-Based Medicine Center, West China Hospital, Sichuan University, Chengdu, 610041, China. .,NMPA Key Laboratory for Real World Data Research and Evaluation in Hainan, Chengdu, 610041, China.
| | - Xin Sun
- Chinese Evidence-Based Medicine Center, West China Hospital, Sichuan University, Chengdu, 610041, China. .,NMPA Key Laboratory for Real World Data Research and Evaluation in Hainan, Chengdu, 610041, China.
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Cito G, Coccia ME, Picone R, Fucci R, Micelli E, Cocci A, Di Mauro M, Rizzello F, Giachini C, Minervini A, Carini M, Natali A. Can cytomegalovirus infection affect male reproductive function? Results of a retrospective single-centre analysis. Andrologia 2020; 52:e13699. [PMID: 32510732 DOI: 10.1111/and.13699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Revised: 04/06/2020] [Accepted: 05/16/2020] [Indexed: 11/28/2022] Open
Abstract
Our objective was to investigate whether the chronic cytomegalovirus (CMV) infection can affect semen parameters in men with couple infertility and to assess the impact of male CMV infection on the reproductive outcomes of CMV-seronegative women suffering from tubal factor. Group 1 included CMV IgG-seropositive men, Group 2 CMV IgG-seronegative patients. Seminal parameters, two-pronuclear (2PN) fertilization rate (FR), 1-2-3PN FR, cleavage rate (CR), miscarriage rate (MR), pregnancy rate (PR) and live birth rate (LBR) were collected. Two hundred and twenty-two men were included: 115 (51.8%) in Group 1 and 107 (48.2%) in Group 2. There was reported a low trend towards higher sperm concentration/ml, total sperm count and viability in CMV IgG-seronegative males, compared to CMV IgG-seropositive (p > .05). Semen volume, pH, motility and normal sperm morphology were similar among groups. Considering the subgroup of men, partners of CMV IgG-seronegative females, 65 couples (29.2%) were selected. Median 2PN FR was 67%, total FR 83%, CR 100%, PR/cycle 26.2%, MR 10.8%, LBR/cycle 15.4%. No significant differences were found regarding the reproductive outcomes between CMV IgG-seropositive men and those seronegative. CMV did not seem to play a key role in male reproductive function, as well as in influencing sperm fertility potential in the assisted reproductive outcomes.
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Affiliation(s)
- Gianmartin Cito
- Department of Urology, Careggi Hospital, University of Florence, Florence, Italy
| | - Maria Elisabetta Coccia
- Assisted Reproductive Technology Centre, Careggi Hospital, University of Florence, Florence, Italy
| | - Rita Picone
- Assisted Reproductive Technology Centre, Careggi Hospital, University of Florence, Florence, Italy
| | - Rossella Fucci
- Assisted Reproductive Technology Centre, Careggi Hospital, University of Florence, Florence, Italy
| | - Elisabetta Micelli
- Department of Gynecology and Obstetrics, St. Claire Hospital, University of Pisa, Pisa, Italy
| | - Andrea Cocci
- Department of Urology, Careggi Hospital, University of Florence, Florence, Italy
| | - Marina Di Mauro
- Department of Urology, Vittorio Emanuele Hospital, University of Catania, Catania, Italy
| | - Francesca Rizzello
- Assisted Reproductive Technology Centre, Careggi Hospital, University of Florence, Florence, Italy
| | - Claudia Giachini
- Assisted Reproductive Technology Centre, Careggi Hospital, University of Florence, Florence, Italy
| | - Andrea Minervini
- Department of Urology, Careggi Hospital, University of Florence, Florence, Italy
| | - Marco Carini
- Department of Urology, Careggi Hospital, University of Florence, Florence, Italy
| | - Alessandro Natali
- Department of Urology, Careggi Hospital, University of Florence, Florence, Italy
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