COVID-19 infections within 10 weeks after embryo transfer is not associated with biochemical pregnancy rate, implantation rate, clinical pregnancy rate, and early miscarriage rate among patients receiving in vitro fertilization (IVF), according to a recent study published in the American Journal of Obstetrics & Gynecology.
Takeaways
- COVID-19 infection within 10 weeks post-embryo transfer doesn't affect in vitro fertilization (IVF) pregnancy outcomes, according to a recent study published in the American Journal of Obstetrics & Gynecology.
- Data from the study reveals no association between COVID-19 infection and biochemical pregnancy rate, implantation rate, clinical pregnancy rate, or early miscarriage rate.
- The study includes patients receiving both IVF and intracytoplasmic sperm injection-embryo transfer (ICSI-ET).
- The analysis categorized patients based on time after embryo transfer, showing consistent results across different stages.
- The findings provide valuable insights into the risks associated with COVID-19 infection following IVF or ICSI procedures, offering reassurance to patients and practitioners.
Concerns have arisen about the potential impact of COVID-19 on fertility, pregnancy, and assisted reproductive technology techniques. While data has indicated susceptibility to COVID-19 infection for male and female reproductive systems, there is little information about the impact of COVID-19 on ovarian reserves and function.
An association between COVID-19 infection prior to oocyte retrieval in IVF and adverse IVF cycle outcomes has not been determined. However, data has linked retrieval over 180 days following infection to potential long-term adverse oocyte yield effects. Therefore, it is necessary to obtain data about the impact of COVID-19 infection during the first trimester.
Investigators conducted a study to evaluate the association between COVID-19 infection within 10 weeks after embryo transfer and early pregnancy outcomes among IVF pregnancies. Patients receiving intracytoplasmic sperm injection–embryo transfer (ICSI-ET) were also included in the analysis.
Electronic medical records were evaluated for IVF and ICSI-ET data. Eligible participants received IVF or ICSI-ET between September 2022 and December 2022, with follow-up occurring until March 2023.
Patients completed a COVID-19 questionnaire either on-site or through telephone surveys. COVID-19 infection was determined using standard diagnostic procedures, and symptom severity was determined based on guidelines in domestic and foreign literature.
The association between COVID-19 infection and outcomes was determined by evaluating patients in categories based on time after embryo transfer, including 14 days or less in stage 1 of the analysis, 28 days or less in stage 2, and 10 weeks or less in stage 3. The day after embryo transfer was considered day 1.
The biochemical pregnancy rate, clinical pregnancy rate, and early miscarriage rate were reported as primary outcomes of the analysis. The implantation rate was reported as the secondary outcome.
There were 136 patients infected within 14 days following embryo transfer and 721 uninfected during this period included in the first stage of the analysis. In the second stage, 171 were infected within 28 days following embryo transfer and 686 were uninfected. In the third phase, 696 were infected within 10 weeks and 161 were uninfected.
The type of transferred embryos and number of high-quality embryos significantly differed between groups in the first stage of the analysis. In the second stage, these factors and the fertilization type differed. In the third phase, follicle stimulating hormone, anti-Müllerian hormone, and controlled ovarian stimulation showed significant differences between groups.
There were no significant variations in biochemical pregnancy rates between infected and uninfected patients in the first stage, with an adjusted odds ratio (OR) of 0.74. In the second stage, there were no differences in the implantation rates between vaccinated and unvaccinated patients, at 36.5% vs 44%, respectively.
A significant difference in the clinical pregnancy rate between groups was observed in the second stage, but this variation did not remain when adjusting for cofounders. In the third stage, early miscarriage rates did not significantly differ between groups, with an unadjusted OR of 0.94. The adjusted odds ratio of 0.77 similarly indicated no association.
These results indicated no association between COVID-19 infection and biochemical pregnancy rate, implantation rate, clinical pregnancy rate, and early miscarriage rate after 10 weeks in patients receiving IVF or ICSI. Investigators concluded this data provides increased understanding of risks associated with COVID-19 infection after IVF or ICSI.
Reference
Li X, Zhang Y, Yao Y, et al. The association of post–embryo transfer SARS-CoV-2 infection with early pregnancy outcomes in in vitro fertilization: a prospective cohort study. Am J Obstet Gynecol. 2024;230:436.e1-12. doi:10.1016/j.ajog.2023.12.022
