Viral Hepatitis and Assisted Reproduction

摘要

Infertility treatment in couples where one or both parents are infected with hepatitis raises many concerns about transmission of the infection to the baby, laboratory technicians, and medical staff, and contamination of other gametes/embryos that are from virus-free parents in the same laboratory. Exposure to the other partner is only a risk when the couple’s hepatitis status is discordant. The management of infertility, in association with HBV or HCV, has sparked debates about the potential risk of spread of infection to virus-free individuals, embryos, and/or semen. This risk can only be minimized or eliminated by the use of SOPs for safety in fertility clinics and by the use of proper initial detection and segregation of potentially hazardous materials. HBV may interfere with the development of embryos and even result in abortion and other adverse outcomes. Although sexual transmission of HCV is very low, in subfertile or infertile couples sperm washing should be used to treat HCV-positive semen before ART. Testing for HBsAg and HCV should be offered to high-risk infertile couples seeking fertility therapy to reduce the potential risk of transmission to an uninfected partner, baby, staff members, and disease-free gametes and embryos in the same laboratory. Testing for HIV, HBsAg, and HCV status should be performed on the couple prior to cryopreservation of semen or embryos.