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目的:通过检测HBV感染父亲体外受精胚胎中的HBV mRNA以明确HBV父婴传播的意义。方法:以慢性HBV感染父亲体外受精后遗弃胚胎为研究对象,用单细胞RT-PCR检测胚胎中的HBV mRNA。结果:父亲HBV血清标志物阳性者而母亲为HBV血清标志物阴性的9例18个废弃胚胎,在1个胚胎中检测到HBVmRNA,阳性率为1/18(5.6%),84个阴性对照胚胎中未检出特异性HBV mRNA。随访发现实验组和阴性对照组之间临床妊娠率分别为33.3%和44.0%,两者之间差异无明显意义(P>0.05);早期流产率分别为33.3%和9.1%,两者之间无明显统计学意义(P>0.05);胚胎中HBV mRNA信号阳性父亲的体外受精胚胎成功种植,但发生了早期流产;两组均未发生子代HBV感染。结论:HBV mRNA的阳性结果证实了HBV可以通过精子进入早期卵裂胚胎并在其中复制,可能是父婴传播的主要途径;而且HBV可能会干扰胚胎的发育,进一步造成流产等不良结果。
OBJECTIVE: To determine the significance of HBV transmission between father and infant by detecting HBV mRNA in HBV-infected in vitro fertilized embryos. Methods: Abortion embryos were obtained from in vitro fertilization of chronic HBV infection and HBV mRNA in embryos was detected by single cell RT-PCR. RESULTS: Totally 18 aborted embryos were obtained from 9 pregnant women whose mothers were positive for HBV seroprevalence and whose mothers were negative for HBV serology, HBV mRNA was detected in 1 embryo, the positive rate was 1/18 (5.6%), 84 negative control embryos No specific HBV mRNA was detected. Follow-up found that clinical pregnancy rates between the experimental group and the negative control group were 33.3% and 44.0% respectively, with no significant difference between the two groups (P> 0.05). The rates of early miscarriage were 33.3% and 9.1% respectively No statistically significant (P> 0.05). Embryos with HBV mRNA positive father in vitro fertilization embryos were successfully planted but early miscarriage occurred. No HBV infection was detected in both groups. Conclusion: The positive result of HBV mRNA confirms that HBV can enter and replicate in early cleavage embryos through sperm, which may be the main way of transmitting between father and baby. HBV may interfere with the development of embryo and cause further adverse effects such as abortion.