Maternal hepatitis B virus infection does not appear to reduce the overall likelihood of pregnancy or live birth following in vitro fertilisation or intracytoplasmic sperm injection, according to a cohort study published in Front Frontiers in Medicine in 2026. However, researchers identified a significantly higher rate of preterm birth among women affected by the virus, pointing to a need for closer obstetric monitoring during assisted reproduction pregnancies.
Assisted-Reproduction Outcomes in Hepatitis B Patients
To evaluate how the virus impacts fertility treatments, researchers retrospectively analysed 3,455 first-time fresh IVF or ICSI embryo-transfer cycles. These procedures were performed at a reproductive medicine centre in China between 2018 and 2020. The study cohort included 811 cycles involving women with maternal hepatitis B virus infection and 2,644 control cycles where neither partner carried the hepatitis B surface antigen. To account for baseline differences between the groups, investigators used propensity-score matching, which successfully produced 810 closely matched pairs for final evaluation across the entire reproductive pathway.
Pregnancy and Live-Birth Rates Remain Comparable
The analysis revealed that maternal hepatitis B infection did not impair early laboratory or clinical success markers. Following matching, researchers found no significant differences in oocyte maturation, normal fertilisation, high-quality embryo development, or blastocyst formation rates between the two groups. Clinical pregnancy rates stood at 44.44% for the hepatitis B group and 45.43% for the control cohort. Similarly, live-birth rates reached 32.59% among women with hepatitis B and 32.96% among control participants. Implantation, miscarriage, stillbirth, and ectopic-pregnancy rates showed no statistical divergence, while gestational complications such as gestational hypertension, gestational diabetes, premature rupture of membranes, and caesarean delivery rates remained comparable.
Elevated Preterm Birth Risk Identified
Despite stable overall success rates, preterm birth emerged as the primary diverging outcome between the cohorts. After matching, 15.73% of births in the hepatitis B group were preterm, compared to 7.78% in the control group. According to the study by W. Jiang and colleagues, the precise biological mechanism driving this association remains uncertain. Potential contributing factors include chronic inflammation, immunological changes, and alterations in placental development. However, the retrospective, single-centre design lacked detailed data regarding viral loads, antiviral treatments, and liver function, preventing researchers from establishing a direct causal link. While the findings offer reassurance that maternal hepatitis B does not compromise the probability of a successful IVF or ICSI procedure, the elevated risk of early delivery underscores the importance of prospective confirmation and heightened obstetric vigilance.
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