Impact of hepatitis B virus carrier status on IVF-ET outcomes across different ovarian reserve levels: A retrospective study

To evaluate the impact of hepatitis B virus (HBV) carrier status on oocyte quality, embryonic development, and pregnancy outcomes in women with varying ovarian reserve undergoing in vitro fertilization and embryo transfer (IVF-ET). This retrospective study included 112 infertile women with HBV carrier status and 104 HBV-negative controls who underwent IVF-ET between December 2020 and December 2024. Participants were stratified by serum anti-müllerian hormone levels into low (<2 μg/L), normal (2–7 μg/L), and high (>7 μg/L) ovarian reserve groups and further categorized as HBV carriers or noncarriers. Key reproductive outcomes – including cleavage rate, implantation rate, normal fertilization rate, high-quality embryo rate, clinical pregnancy rate, and miscarriage rate – were compared between groups. Across all ovarian reserve strata, HBV carriers exhibited significantly higher rates of unavailable embryos ( P <.05). Within the normal ovarian reserve group, HBV carriers had significantly lower cleavage rate, implantation rate, normal fertilization rate, high-quality embryo rate, and clinical pregnancy rate compared to noncarriers ( P <.05). No significant differences were observed in the low or high ovarian reserve groups. Miscarriage rates were elevated among HBV carriers across all ovarian reserve categories ( P <.05). HBV infection may adversely affect oocyte quality and embryonic development, particularly in women with normal ovarian reserve, resulting in compromised IVF-ET outcomes. These findings highlight the potential need for early reproductive intervention in this population.