Hepatitis B virus infection is associated with impaired sperm quality: a retrospective cohort study of 1566 infertile men

Background Hepatitis B virus (HBV) infection is a major global health issue, affecting millions of individuals worldwide. Chronic HBV infection is associated with various systemic health complications, including liver disease with its impact on reproductive health in male fertility. Methods This study investigated the impact of HBV on sperm quality in a cohort of 1566 male infertile patients undergoing assisted reproductive treatment from 2021 to 2024. Patients aged 23 to 40 years (mean age 34.2 ± 3.62 years) were categorized into HBV-positive (783 cases) and HBV-negative (783 cases) groups based on serological tests for hepatitis B surface antigen (Hbs Ag). Results HBV-positive and HBV-negative groups exhibited significantly lower progressive motility (41.3% vs. 43.0%; P = 0.006), sperm concentration (53.6 vs. 59.8 × 10 6 /mL; P = 0.009), and normal morphology (4.5% vs. 5.0%; P < 0.001), with reduced viability ( P = 0.027). No differences were observed in semen volume ( P = 0.807) or DNA fragmentation index ( P = 0.970). Conclusion HBV infection is associated with impaired sperm motility, concentration, and morphology in infertile men.