China is a major hepatitis B country, and vertical transmission of HBV used to be the most important way of transmission of HBV infection. There have been numerous family tragedies due to family aggregation of HBV infection. With the improvement of patients’ health knowledge, many chronic HBV-infected patients (hepatitis patients) prefer not to have children rather than bring the pain of the disease to the next generation. More young people of childbearing age who are looking forward to having a healthy baby hope to prevent their children from becoming infected through treatment. However the lack of a clear endpoint of treatment brings them a new confusion: to stop medication before childbirth, or not to stop medication, is a difficult question ………… As a hepatologist, I would like to talk about my own perceptions. HBV father-to-be’s fertility problem. If the father-to-be is HBV-DNA positive, it has the possibility of father-to-child transmission; if it belongs to the HBV-DNA negative situation, the probability of transmission is negligible, and I think there is no need for special measures to prevent it, and this article will not discuss it. There are two ways of father-to-child transmission, one way is the infection caused by the sperm itself carrying the virus, which is true vertical transmission; the other is the infection caused by close living contact between the child and the father during early childhood, which belongs to horizontal transmission. The probability of paternal-infant transmission is not high, with some surveys showing that the overall proportion of paternal-infant transmission in the population for both modes of transmission is only 5%. This is a statistically small probability event, so there is really no need to worry too much. However, even a small problem is a problem, and the following are some thoughts on father-to-child transmission and its interruption. The methods to interrupt father-to-child transmission are as follows: reduce the infectiousness of the father-to-be, reduce the probability of HBV transmission during conception, reduce the close living contact between the infant and the father, and increase the infant’s ability to resist infection. Reducing the infectiousness of the father-to-be mainly lies in controlling his serum HBV-DNA level. Although the reproductive system is not a susceptible area for HBV, there are still studies suggesting that semen contains very low levels of hepatitis B virus. Antiviral treatment can help reduce systemic HBV load and theoretically further reduce HBV load in semen, which can help further reduce vertical transmission from father to child. For fathers-to-be with evidence of hepatitis B treatment, receiving treatment means that they are controlling father-to-child transmission and should not hesitate to do so. What can be done to reduce HBV transmission during conception? Vaccination of the mother-to-be with a high titer of protective antibodies (HBsAb) is the main tool. A high carrier level of HBsAb helps to reduce HBV transmission between couples and therefore is presumed to reduce the infectivity of HBV male semen. Some investigations have confirmed that HBV infection occurring before the age of 5 years is more likely to be chronic at younger ages. Therefore the level of close contact with HBV-DNA positive fathers should be reduced at a younger age in children. However, HBV-DNA-negative fathers should not be subject to this restriction with young children who have already acquired higher titers of HBsAb. In terms of increasing the infant’s resistance to infection, this refers mainly to hepatitis B vaccination and the use of hepatitis B immunoglobulin. free and standardized neonatal hepatitis B vaccination has been introduced in China since the 1980s, and this universal vaccination has been effective in increasing the ability of affected children to resist HBV infection. The chance of horizontal transmission from father to child will be greatly reduced. With careful control, it is not difficult to interrupt father-to-infant transmission. Despite the clear principles, there are still clinical complications that make it difficult for hepatitis B fathers-to-be to judge, which are mainly related to the following issues. One is the question of whether abnormal liver function is fertile, which can also be interpreted as the question of whether hepatitis will affect the quality of fertility. Abnormal liver function obviously indicates that there is still virus in the liver that needs to be cleared, in other words, most of such fathers-to-be are infectious. In addition, I think it is a natural rule that fertility should be selected when the body is in the best condition. However, abnormal liver function is obviously in a disease state, and conception is not suitable at this time. Therefore, I personally do not support conception in patients who are in the stage of hepatitis. Another common question is whether nucleoside antivirals can affect the quality of fertility. Nucleoside antivirals act directly on the viral polymorphic enzymes and are drugs that work at the genetic level. Fortunately, nucleoside antivirals are quite selective and have little effect on human genetic replication at regular doses. Lamivudine has been used for more than 10 years and no clear reports of adverse effects on fertility have been reported. Other nucleoside analogues have been used for varying lengths of time, but there are no similar reports. Finally, there is the question of how to impregnate HBV carriers with normal liver function. I believe that after immunization of the mother-to-be, normal conception is sufficient without the need for early antiviral treatment. Some questions about conception in mothers-to-be with chronic hepatitis B. There are more studies and evidence for diagnosing mother-to-child blockade, and there are already guideline documents published, or you can consult the obstetrics and gynecology department of our hospital. This article will not go into detail. Finally, I wish all families who are troubled by HBV a healthy and beautiful baby soon!