In vitro fertilization in patients with hepatitis b

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Hepatitis is an inflammatory disease of the liver that can be chronic or acute and can cause serious long-term consequences. It can be transmitted by fluids such as blood, by sexual contact and can also be transmitted vertically, that is, from mother to child, particularly at the time of birth.

Currently, we have a wide variety of assisted reproduction techniques, among which are in vitro fertilization (IVF) and intracytoplasmic sperm microinjection (ICSI), which help us solve many sterility and infertility problems.

In some cases, patients with viral infections appear, including Hepatitis B virus (HBV). For reasons of safety both for the parents, as for the future child, as well as for the health and laboratory personnel, the protocol for the couple has been protocolized for quite some years.

Below you have an index with all the points that we will discuss in this article.

Index

In vitro fertilization in patients with Hepatitis B

When this infectious disease can be transmitted to the offspring, can a couple with hepatitis B have a healthy child by in vitro fertilization ? Is there a risk of disease transmission also in this process?

Hepatitis B virus

What happens when the male has hepatitis B?

When the couple arrives at the fertility clinic, an analytical is done to both to determine if there is presence of the hepatitis B virus in blood in either of them.

In case the male is affected there may be transmission to the woman through sexual contact and through semen, so it is important to determine if the virus is present before being able to do the necessary assisted reproduction treatment.

If the male has chronic hepatitis B, it is necessary to vaccinate the woman first and then check if there is a correct immunization against the virus thanks to the vaccine. This is necessary both before starting an assisted reproduction treatment and in a natural pregnancy.

Determine the presence of hepatitis B virus in the blood

If virus is in active phase, the virus will be present in semen, so it is necessary to do a seminal wash to ensure that the treatment is done with virus-free sperm. This minimizes the risk of contagion.

Therefore, couples in which the man has hepatitis can have children for assisted reproduction thanks to the seminal wash, thus avoiding the transmission of the disease to the couple and the baby.



What happens if the woman has hepatitis B?

If the woman tests positive for hepatitis B, it can be more problematic, since in pregnancy the vertical transmission of the virus to the baby may occur, both during fetal development and during delivery.

In this case it is necessary to vaccinate the spouse to avoid contagion due to the disease. Then you have to measure the viral load in blood to decide if you can perform the technique of assisted reproduction or if it is necessary to wait until the viral load is lower.

When the viral load is non-existent or low, an artificial insemination can be performed with the semen of the couple or an in vitro fertilization. Once the woman gives birth to the baby, immunoprophylaxis must be done to the newborn, that is, vaccinate against hepatitis B and administer a specific immunoglobulin against HBV to be protected.

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