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Can Hepatitis B be transmitted during IVF?

Pregnancy Gynaecology Gastroenterology

My husband is negative for Hep B, while I am a Hep B carrier. We wish to undergo IVF. Is this possible, and will the embryo be infected with Hep B?

DOCTOR’S ANSWER (2)

Hepatitis B is transmitted from mother to child at birth, not at the time of conception. Hence, Hepatitis B is not an issue for IVF, as the virus cannot be transmitted at IVF. 

If the IVF is successful, you would be no different from many other Hepatitis B mothers. To prevent transmission at birth, your baby will need Hepatitis B vaccination and immunoglobulin within 12 hours of birth.

During pregnancy, your obstetrician will monitor your liver function and Hepatitis B viral load. If the viral load is very high, the risk of transmission to the baby at birth increases despite the usual precautions. If so, you may need to see a liver specialist to start medication for Hepatitis B to further decrease the risk. 

If you have not done so before, you may want to consult a liver specialist for a proper liver assessment even before pregnancy.

Regards 

313 views 25 Dec 2018

Great question. This is a complex discussion that requires the input of both your gastroenterologist and IVF doctor. 

Current evidence states that the transmission of viral hepatitis in assisted reproduction is possible, but the degree of risk is unknown.

Your partner who is negative for Hep B should be vaccinated against Hep B. Once his anti-hepatitis B surface antibody titer (HBsAB) is positive, you can commence with IVF treatment. 

As for yourself, the risk of Hep B transmission from mother to child during an IVF procedure is no different from spontaneous pregnancy, and thus "there is no reason to advise against an IVF procedure in Hep B carriers" (Steyaert et al., 2000). 

For protection and to minimise the risk of Hep B transmission, your newborn should receive immunoprophylaxis within 12 hours after birth. This consists of both HBV vaccine and immunoglobulin, and is repeated when he or she is 6 months old.

After your newborn has received immunoprophylaxis, you can breastfeed him/her. 

Here're some good resources for further reading:

https://www.fertstert.org/article/S0015-0282(06)03367-X/fulltext#sec5.2 

https://www.ncbi.nlm.nih.gov/pubmed/11045874

https://academic.oup.com/humrep/article/24/11/2676/626319

359 views 24 Dec 2018
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