Care programme for prospective parents with an infectious disease

The CRG of UZ Brussel has a worldwide reputation for its expertise in Assisted Reproductive Treatment (ART) and all related treatments.
In our work, patient care is key and over the years we have always paid a great deal of attention to improving – in terms of comfort and effectiveness – our treatments.

Based on this philosophy, we have developed an appropriate treatment plan (or care programme) for prospective parents with an infectious disease.
Whether you are a man or a woman who is infected, or perhaps you are both infected, it is possible to bring a healthy child into the world.

Care programme for hepatitis B

Preventive measure

If one of the two partners is infected with hepatitis B, we always recommend that the other partner be vaccinated. A vaccine against hepatitis B is available and effective.

Hepatitis B is a viral condition which infects the liver.
The infection is mainly transmitted by contact with infected blood or bodily fluids. The main sources of infection are:
  • the bodily fluids exchanged during sexual intercourse; and
  • infected material (e.g. needles) during intravenous drug use, when performing tattoos, piercings or acupuncture.

Hepatitis B is not spread via food or water nor by chance-contact such as cuddling, kissing or sharing food or drink with an infected person.
Hepatitis B often goes unnoticed. A number of people who have been infected remain carriers of the virus after the infection has passed. We call these ‘healthy carriers’: they themselves are not ill, but they are potentially infectious to others.
However, in some patients the infection does remain active, which makes it more transmissible. They also have an increased risk of liver damage (including cirrhosis of the liver).

Apart from the aforementioned ways - exchange of infected bodily fluids and blood - transmission of hepatitis B is also possible via infected eggs, sperm and embryos.
Hence the legal obligation of fertility centres to test for infection every three months over the course of an ART treatment.

A baby is exposed to the risk of infection dring birth by contact with blood or other bodily fluids from the mother. The risk of transmission via the placenta during pregnancy is, although very low, not impossible.

Before pregnancy

During the preliminary tests we check whether you are a carrier of the virus or have active chronic hepatitis, and whether there is any liver damage.
If you have active hepatitis, you may have to be treated first.
If significant liver damage (cirrhosis) is detected, it is generally a contraindication to becoming pregnant.

During pregnancy

In most cases, the course of a pregnancy is not affected by the hepatitis B infection:
  • if you are a ‘healthy carrier’, it is unlikely that your foetus will become infected or that it will have any problem specifically related to the infection;
  • if you have chronic hepatitis B with a high viral load, we recommend that you be treated, thereby reducing the risk of infection for the baby.

Delivery

The presence of a hepatitis B infection does not affect the type of delivery.
Both a vaginal delivery and a caesarean section are possible.

After birth

During birth, the baby can come into contact with the virus and could be potentially infected. To protect your baby, we will administer an injection with antibodies against hepatitis B and vaccinate him/her a few hours after birth.

Before pregnancy

During the preliminary tests we check whether you are a carrier of the virus or have active chronic hepatitis, and whether there is any liver damage.

If you have active hepatitis, you may have to be treated first.
We only start an ART treatment if the (female) partner has been vaccinated and as soon as she has developed sufficient antibodies.
For each ART treatment, your sperm will undergo a (standard) washing procedure. As a result of this, the risk of transmission to the child is considerably reduced.

Recent studies show that a chronic hepatitis B infection can have a negative effect on the quality of the sperm. The CRG doctor may prescribe ICSI because of this. This technique requires fewer sperm.

During pregnancy and delivery, and after birth

A hepatitis B infection in the man has no effect on the course of pregnancy and birth, or during the period following birth. You don't need additional protection during intercourse if your partner has been vaccinated.