Can Hepatitis B Affect Male Fertility?

A diagnosis of hepatitis B raises many questions, and one of the most frequent is about family planning. If you or your partner has tested positive, you may be wondering: can hepatitis B affect male fertility, and will it interfere with having a baby? Here's why this question matters and what the evidence really says.

The short answer is that hepatitis B can affect male fertility in measurable ways, but a diagnosis does not mean you can’t become a father. So let’s take it step by step, from what the virus does in your body to what UK fertility guidelines say about planning a pregnancy safely.

What Is Hepatitis B?

Hepatitis B is a liver disease caused by the hepatitis B virus (HBV). It is spread through the blood and body fluids such as semen, which is why sexual contact is one of the major routes of transmission in adults. Most people get rid of the infection within a few months, but some go on to develop chronic hepatitis B, which can last for years and can cause scarring of the liver or liver cancer if left untreated, the NHS said.

In the UK, however, chronic infection is relatively rare because babies are routinely vaccinated as part of the 6-in-1 jab. Adults at higher risk, such as healthcare workers and people travelling to countries with high prevalence, are also offered the vaccine.

Can Hepatitis B Affect Male Fertility?

Yes, research is increasingly showing a real link between hepatitis B and male fertility, especially in men with a chronic infection.

A retrospective study of 1,566 infertile men published in the Middle East Fertility Society Journal in 2025 found that men with hepatitis B had lower sperm concentration, lower progressive motility, and a smaller proportion of normally shaped sperm compared with men who were HBV-negative. Another cohort study from Harbin Medical University, published in Frontiers in Medicine, reported similar findings: men with chronic HBV infection had lower sperm viability and motility than uninfected men undergoing the same fertility treatment.

To confirm the pattern, a systematic review and meta-analysis of BMC Urology pooled data from multiple studies, describing a consistent association between HBV infection and reduced semen quality across different populations.

None of that means hepatitis B outright causes infertility. That means the virus can alter the odds a little bit by changing the way sperm are made, move, and function.

How Hepatitis B May Affect Sperm Quality

Researchers have pinpointed several ways in which the virus seems to disrupt reproductive function.

• Lowered sperm concentration. Several studies report fewer sperm per millilitre of semen in HBV-positive men compared with HBV-negative men.

• Decreased motility. Sperm need to be good swimmers to reach an egg and fertilise it. Chronic HBV infection has been associated with slower and less coordinated sperm motility.

• Even weirder sperm shapes. The virus is associated with a higher rate of abnormal morphology in men, studies have found, which can reduce the chances of natural conception.

• Damage to DNA and mitochondria. Some studies show that HBV could affect the genetic material of sperm cells and the mitochondria that fuel the movement of sperm.

• Direct presence of the virus in the semen. One reason that clinics take precautions during fertility treatment is that HBV DNA has been detected in the semen of infected men.

It is worth noting that most of these studies compare group averages. One man with hepatitis B may have totally normal semen parameters, and another man without the virus may have poor sperm quality for other reasons (smoking, weight, age).

Hepatitis B and Fertility Treatment in the UK

There is specific guidance on this from NICE in the UK if a man has hepatitis B, and the couple is contemplating fertility treatment. If one partner is infected with hepatitis B, the partner who is not infected should be offered the hepatitis B vaccine, because the infection can be spread through unprotected sex. Sperm washing is not routinely offered to men with hepatitis B before fertility treatment (as occurs sometimes with HIV), according to NICE guidance.

In the UK, fertility clinics are regulated by the Human Fertilisation and Embryology Authority (HFEA) and must screen for blood-borne viruses, including hepatitis B, before treatments such as IVF, ICSI, or sperm and egg storage can proceed. This protects the couple and any embryos or gametes stored along with theirs in the lab. Research into IVF and ICSI outcomes, including the cohort in Frontiers in Medicine mentioned above, found that although sperm quality was lower in HBV-positive men, the fertilisation rates, pregnancy rates, and live birth outcomes through assisted reproduction were broadly similar to those of unaffected couples.

Can Men With Hepatitis B Still Have Biological Children?

1. Yes, most of the time. Chronic hepatitis B does not prevent a man from fathering children. Practical steps normally include:

2. Undergoing testing and monitoring. A hepatitis specialist can measure viral load and liver function, which can help guide treatment decisions before trying to conceive.

3. Vaccination of partners. If the female partner is not immune, vaccination reduces the risk that she will acquire the virus.

4. Timing of discussion of antiviral therapy. Some men are on antiviral drugs for HBV, and doctors can advise on whether changes are needed around conception.

5. Semen test. A basic fertility check, including a semen analysis, gives a better picture of sperm count, motility, and morphology rather than making assumptions based on the diagnosis alone.

6. Specialist fertility support if you don’t conceive naturally. If pregnancy does not occur in the expected time frame, options such as IUI, IVF, or ICSI with appropriate screening are available.

Protecting Your Partner and Future Family

Because hepatitis B is spread through body fluids, couples where one partner is infected with the virus are usually advised to use condoms until the other partner is vaccinated and proven to be immune. If the mother has hepatitis B, the newborn will receive extra doses of the vaccine at birth to reduce the risk of infection transmission during delivery. Hence, preconception planning with a doctor is important for both partners, not just the man.

When to Speak to a Doctor

If you or your partner has hepatitis B, and you’re considering having a baby, it’s worth talking to a doctor before you start trying. This allows for checking viral load, review of any medication, confirmation of the partner's immunity status, and arranging a semen analysis if required. Whether or not they have hepatitis B, couples trying to conceive for 12 months without success (6 months if the woman is over 35) should also have a fertility assessment.

MyGynaePlus also has consultants who help couples with fertility issues and preconception advice, especially where one of the partners has a chronic condition like hepatitis B. If you are uncertain how a health condition may affect your family planning, myGynaePlus provides consultations to discuss your individual case and next steps. At myGynaePlus, we’re here to help you work through this, as getting clear, personalized guidance early on tends to make the whole process feel far less overwhelming.

Frequently Asked Questions

Does hepatitis B always cause male infertility? 

No. Research has shown a correlation between hepatitis B and decreased sperm quality on average, but many men with the virus have normal semen parameters and conceive naturally. A diagnosis alone does not give as clear an individual picture as an analysis of semen.

Can hepatitis B be passed to a baby through sperm? 

The primary risk of transmission in pregnancy is from the mother at birth, not the sperm at conception. This risk is mitigated by giving extra doses of vaccine to the newborns of hepatitis B-positive mothers at birth.

Should a man with hepatitis B have sperm washing before IVF? 

UK guidance from NICE says men with hepatitis B are not routinely offered sperm washing before fertility treatment, as the risk of passing on the infection during assisted conception is controlled with vaccination and screening.

Can antiviral treatment for hepatitis B affect sperm quality? 

“Some studies show untreated chronic infection is more associated with poor sperm quality than treated infection, but more studies are underway.” Hepatitis specialists can advise on the timing of treatment around conception.

What tests are needed before trying to conceive if one partner has hepatitis B? 

This usually involves viral load and liver function testing for the infected partner, immunity testing (and vaccination if necessary) for the other partner, and a semen analysis to check sperm count, motility, and shape.