The Impact of the Coronavirus Disease 19 Pandemic on Early Pregnancy Outcomes Among Patients Undergoing In Vitro Fertilization Treatment

Assisted Reproductive Technology During COVID-19: A Population-Based Study Of Pregnancy Outcomes

We assessed the impact of the COVID-19 pandemic on the pregnancy outcomes of patients who used assisted reproductive technology. We conducted a population-based cohort study of 443,101 patients who conceived naturally or with assisted reproductive technology between December 2015 and July 2021 and had a delivery in hospitals of Quebec, Canada. The main exposure measure was use of assisted reproductive technology before or during the pandemic. Outcomes included preeclampsia, preterm birth, and other pregnancy complications. We used adjusted log-binomial regression models to estimate risk ratios (RR) and 95% confidence intervals (CI) for the association of assisted reproductive technology with adverse pregnancy outcomes compared with natural conception before vs. during the pandemic. In secondary analyses, we examined the association of COVID-19 infection with pregnancy outcomes among women who used assisted reproductive technology. Compared with natural conception, assisted reproductive technology was associated with an increased risk of preeclampsia (RR 1.43; 95% CI 1.21-1.68), preterm birth (RR 2.07; 95% CI 1.84-2.33), and low birth weight (RR 1.94; 95% CI 1.72-2.20) during the pandemic. However, the same risks were also present before the pandemic. Compared with no infection, COVID-19 infection was not associated with adverse outcomes among women who conceived with assisted reproductive technology. This study suggests that the COVID-19 pandemic did not significantly impact the pregnancy outcomes of women who underwent assisted reproductive procedures in Quebec. The findings are reassuring for patients concerned about the potential reproductive effects of the pandemic.

Impacts of the COVID-19 pandemic on early pregnancy outcomes among women undergoing frozen-thawed embryo transfer: a retrospective cohort study

The effect of COVID-19 pandemic on early pregnancy outcomes among women undergoing frozen-thawed embryo transfer (FET) remains unclear. We aimed to evaluate whether early pregnancy outcomes were altered in patients undergoing FET during the pandemic. In this retrospective cohort study, women conceived through FET in 2016-2021 from two hospitals in China were included. The early pregnancy outcomes were compared using Logistic regression model, including biochemical pregnancy rate (BPR), clinical pregnancy rate (CPR), and early pregnancy loss rate (EPLR). A total of 16,669 (67.2%) and 6,113 (26.8%) FET cycles enrolled before and during the pandemic, respectively. Univariate analyses showed that women undergoing FET during the pandemic had significantly increased BPR (72.9% vs. 69.7%) and CPR (59.5% vs. 55.0%), and significantly decreased EPLR (13.7% vs. 16.7%) compared to pre-pandemic (all P < 0.001). Moreover, after adjustment, the results were in accordance with univariate analysis for CPR [adjusted OR (95%CI) = 1.08 (1.01-1.14)] and EPLR [adjusted OR (95%CI) = 0.82 (0.73-0.91)], while the statistical significance between BPR and the pandemic disappeared. In summary, women conceived by FET did not have a reduced possibility of clinical pregnancy and a higher risk of early pregnancy loss during the pandemic compared with the pre-pandemic.

Embryo development, pregnancy and live birth outcomes following IVF treatment were not compromised during the COVID-19 pandemic

PURPOSE

To evaluate whether outcomes of in vitro fertilization (IVF) are affected during the coronavirus disease-19 (COVID-19) pandemic.

METHODS

This was a single-center, retrospective study. Embryo development, pregnancy, and live birth outcomes were compared between COVID-19 and pre-COVID-19 groups. Blood samples from patients during the COVID-19 pandemic were tested for COVID-19.

RESULTS

After 1:1 random matching, 403 cycles for each group were included in the study. The rates of fertilization, normal fertilization, and blastocyst formation were higher in the COVID-19 group than in the pre-COVID-19 group. No difference was observed in the rates of day 3 good-quality embryos and good-quality blastocysts between the groups. A multivariate analysis showed that the live birth rate in the COVID-19 group was higher than that in the pre-COVID-19 group (51.4% vs. 41.4%, P = 0.010). In fresh cleavage-stage embryo and blastocyst transfer cycles, there were no differences between the groups in terms of pregnancy, obstetric, and perinatal outcomes. In the freeze-all cycles, the live birth rate was higher during the COVID-19 pandemic (58.0% vs. 34.5%, P = 0.006) than during the pre-COVID-19 period following frozen cleavage stage embryo transfer. The rate of gestational diabetes during the COVID-19 pandemic was higher than that during the pre-COVID-19 period (20.3% vs. 2.4%, P = 0.008) following frozen blastocyst transfer. All the serological results of the patients during the COVID-19 pandemic were negative.

CONCLUSION

Our results indicate that embryo development, pregnancy, and live birth outcomes in uninfected patients were not compromised during the COVID-19 pandemic at our center.

COVID-19 mRNA vaccines have no effect on endometrial receptivity after euploid embryo transfer

RESEARCH QUESTION

Does the COVID-19 vaccination affect endometrial receptivity after single euploid embryo transfer, measured by sustained implantation rate?

DESIGN

A retrospective cohort study analysing two groups of single euploid embryo transfers using own oocytes: one historical cohort of 3272 transfers 1 year before the pandemic; and one comprising 890 transfers in women previously vaccinated with mRNA vaccines against severe acute respiratory syndrome coronavirus 2. The main outcomes were clinical pregnancy rate (CPR) and sustained implantation rate (SIR) per embryo transfer. These outcomes were compared between non-vaccinated and vaccinated women, and women who had received one and two doses. Lastly, vaccinated women were divided into quartiles according to the time from last dose to embryo transfer.

RESULTS

Similar CPR and SIR were found between non-vaccinated and vaccinated women, and the odds ratio for both outcomes was not statistically significant after being controlled for potential confounders (OR 0.937, 95% CI 0.695 to 1.265 and OR 0.910, 95% CI 0.648 to 1.227 respectively). Within the vaccinated group, women who had received one or two doses also had similar outcomes. In addition, no differences were found according to the time interval from vaccination to embryo transfer.

CONCLUSION

The administration of mRNA vaccines against COVID-19 had no effect on endometrial receptivity and embryo implantation, regardless of the number of doses and time interval from vaccination to embryo transfer. The potential negative effect of the vaccine on endometrial receptivity and reproductive outcomes is reassuring for patients in the process of undergoing assisted reproductive treatment.

Impact of COVID-19 pandemic on the pregnancy outcomes of women undergoing assisted reproductive techniques (ARTs): a systematic review and meta-analysis

The global outbreak of the coronavirus disease 2019 (COVID-19) led to the suspension of most treatments with assisted reproductive technique (ART). However, with the recent successful control of the pandemic in China, there is an urgent public need to resume full reproductive care. To determine whether the COVID-19 pandemic had any adverse effects on female fertility and the pregnancy outcomes of women undergoing ART, a systematic review and meta-analysis was conducted using the electronic Chinese and English databases. Dichotomous outcomes were summarized as prevalence, and odds ratios (ORs) and continuous outcomes as standardized mean difference (SMD) with 95% confidence interval (CI). The risk of bias and subgroup analyses were assessed using Stata/SE 15.1 and R 4.1.2. The results showed that compared with women treated by ART in the pre-COVID-19 time frame, women undergoing ART after the COVID-19 pandemic exhibited no significant difference in the clinical pregnancy rate (OR 1.07, 95% CI 0.97 to 1.19; I²=0.0%), miscarriage rate (OR 0.95, 95% CI 0.79 to 1.14; I²=38.4%), embryo cryopreservation rate (OR 2.90, 95% CI 0.17 to 48.13; I²=85.4%), and oocyte cryopreservation rate (OR 0.30, 95% CI 0.03 to 3.65; I²=81.6%). This review provided additional evidence for gynecologists to guide the management of women undergoing ART treatment during the COVID-19 pandemic timeframe.

The Effects of City Lockdown Policy on Frozen Embryo Transfer Outcome during COVID-19 Epidemic in Hubei Province, China

Objective

To evaluate whether there is a difference in clinical pregnancy rate and live birth rate between the corresponding period in 2019 and COVID-19 city lockdown period in 2020 in frozen embryo transfer (FET).

Methods

In one single in vitro fertilization (IVF) center (Shiyan, Hubei province, China), a retrospective cohort analysis was conducted, with a sample size of 59 patients in the lockdown period (2020.1.23-2020.2.23, 2020 group) and 34 patients in the corresponding 2019 period (2019.1.23-2019.2.23, 2019 group). Implantation, biochemical and clinical pregnancy, miscarriage, and live birth rates were all measured.

Results

Age, basal serum follicle-stimulating hormone (FSH), basal serum luteinizing hormone (LH), basal serum E2, and serum total T were all comparable between the two groups. On the day of progesterone administration, endometrial thickness was similar (8.5 ± 1.3 vs. 8.2 ± 1.4, P = 0.356). The number of transferred blastocysts was not significantly different. The two groups had similar clinical pregnancy rate (61.8% vs. 61.0%, P > 0.05) and live birth rate (47.1% vs. 49.2%, P > 0.05), which did not significantly differ. Nonetheless, there was a significant difference in the cancelled cycle rate between the two groups (0% vs. 28.0%, P = 0.043).

Conclusions

Lockdown period FET versus corresponding period FET outcome did not show any significant difference in terms of pregnancy rate and live birth rate between two groups of patients. Although there was no significant difference, in the 2020 group, the live birth rate was higher compared with that in the 2019 group. There was a significant difference in the rate of cancelled cycles due to the seal off control. In summary, artificial endometrial preparation is an appropriate protocol for special periods.

Impact of COVID-19 on Infertility Treatments: Not Even a Global Pandemic Was Strong Enough to Hamper Successful Pregnancies

The COVID-19 global pandemic has meant a sanitary and social threat at every level and it was not any different for the assisted reproduction industry. This retrospective two-arm study aims to describe its impact on infertility treatments performed in our clinics (IVI Spain, Rome, and Lisbon) regarding: (1) assessment of COVID-19 impact in the amount, type, and success of infertility treatments performed during 2020 compared to 2019; and (2) description of the psychological status of women who got pregnant during the first months of the pandemic and its correlation with their final pregnancy outcome. On the one hand, this pandemic has led to a significant reduction in the total number of treatments performed, even though the proportion of the different types was almost unaltered. Additionally, its impact on pregnancy rates was not clinically relevant. On the other hand, the psychological status of pregnant women did not seem to affect their final pregnancy outcome. These results suggest that, even in the event of a negatively affected psychological status in our study population, it was not translated into an impaired pregnancy outcome. Hence, the COVID-19 global pandemic, although devastating, might not have exerted a clinically relevant negative impact on the overall pregnancy outcome in our clinics.