Effect of hepatitis B virus infection in males on pregnancy outcomes of intrauterine insemination

China has a high prevalence of the hepatitis B virus (HBV), and many patients seeking assisted reproductive technologies are infected. This study investigated the relationship between male HBV infection and intrauterine insemination (IUI) outcomes. We retrospectively analyzed 1,686 IUI cycles performed at the Assisted Reproductive Center of Zhongshan City People's Hospital from January 2015 to September 2023. Couples in which the male partner was HBV-infected and the female partner uninfected comprised the study group, while couples in which neither partner was infected formed the control group. Propensity score matching ensured comparability between groups, yielding 88 cycles in the study group and 311 in the control group. Post-matching analysis revealed no significant differences in hCG positivity rate, clinical pregnancy rate, preterm birth rate, low birth weight rate, mean birth weight, or gender ratio (P > 0.05). However, early pregnancy loss was significantly higher in the HBV-infective group compared to the HBV-uninfective group (43.75% vs. 14.00%, P < 0.05). Generalized estimating equation analysis confirmed that male HBV infection increased the risk of early pregnancy loss (adjusted OR = 7.022; 95% CI 1.889-26.100; P < 0.05). Our results suggest that male HBV infection is associated with a higher rate of early pregnancy loss.