LAUSR

Hepatitis B virus (HBV) incorporates into spermatozoa which raises safety concerns about paternofetal transmission performing intracytoplasmatic sperm injection (ICSI) in men with chronic hepatitis B (cHB). HBV reduces sperm cell motility, assuming spermatozoa with highest motility are least HBV‐incorporated. This study investigates an ICSI preparation technique (swim‐up) to isolate most motile spermatozoa in order to select HBV‐free spermatozoa. Semen and blood samples were collected from four patients with cHB. Spermatozoa were incubated in trajectories of gamete medium to create non‐motile, motile/non‐progressive and motile/progressive fractions. After DNA‐extraction, HBV DNA loads were determined in every fraction. Participants (mean age 31) were HBsAg+(4/4), anti‐HBc+(4/4) and HBV DNA+(2/4). They were treated (3/4) with entecavir(1/4) or tenofovir (2/4) and had no adverse sperm parameters(3/4). CRP‐gene was detected in 95/96 sample fractions, proving successful DNA‐extraction. HBV DNA was detected in none of the sample fractions, except for the motile, non‐progressive fraction of one patient (HBeAg+, HBV DNA+). Since no HBV DNA was detected in progressive fractions, this study suggests swim‐up a successful strategy to select HBV‐free spermatozoa. Since all but one fraction was HBV DNA‐negative, this study also suggests that patients with well‐controlled disease have no HBV‐contaminated sample fractions. This study encourages evaluation of guidelines restricting reproductive possibilities in men with cHB.