Trawick Emma, Babayev Elnur, Potapragada Nivedita, Elvikis Jennifer, Smith Kristin, Goldman Kara N
Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.
Womens Health Rep (New Rochelle). 2022 Jan 31;3(1):31-37. doi: 10.1089/whr.2021.0107. eCollection 2022.
Throughout COVID-19, our clinic remained operational for patients requiring urgent fertility preservation (FP). This study aimed to characterize changes to clinical protocols during the first wave of COVID-19 and compare outcomes to historical controls. We performed a retrospective cohort study at a university fertility center examining all patients who underwent medically indicated FP cycles during the American Society for Reproductive Medicine (ASRM) COVID-19 Task Force-recommended suspension of fertility treatment (March 17-May 11, 2020) and patients from the same time period in 2019. FP care was modified for safety during the first wave of COVID-19 with fewer monitoring visits and infection control measures. FP cycle characteristics and outcomes were compared across years. The volume of cycles was nearly 30% higher in 2020 versus 2019 (27 vs. 19). Diagnoses, age, and anti-Mullerian hormone were similar between cohorts. More patients elected to pursue embryo cryopreservation over oocyte cryopreservation in 2020 versus 2019 (45.8% vs. 5.2%, < 0.005). Patients managed during COVID-19 had fewer monitoring visits (5 ± 1 vs. 6 ± 1, = 0.02), and 37.5% of cycles utilized a blind trigger injection. There was no difference in total days of ovarian stimulation (11 ± 1 vs. 11 ± 2, > 0.05), but 2020 cycles utilized more gonadotropin (4770 ± 1480 vs. 3846 ± 1438, = 0.04). There was no difference in total oocytes retrieved (19 ± 14 vs. 22 ± 12, > 0.05) or mature oocytes vitrified (15 ± 12 vs. 17 ± 9, > 0.05) per cycle. FP continued during COVID-19, and more cycles were completed in 2020 versus 2019. Despite minimized monitoring, outcomes were optimal and equivalent to historical controls, suggesting FP care can be adapted without compromising outcomes.
在整个新冠疫情期间,我们的诊所一直为有紧急生育力保存(FP)需求的患者提供服务。本研究旨在描述新冠疫情第一波期间临床方案的变化,并将结果与历史对照进行比较。我们在一家大学生育中心进行了一项回顾性队列研究,调查了在美国生殖医学学会(ASRM)新冠疫情特别工作组建议暂停生育治疗期间(2020年3月17日至5月11日)接受医学指征性FP周期治疗的所有患者,以及2019年同一时期的患者。在新冠疫情第一波期间,为了安全起见,对FP护理进行了调整,减少了监测访视次数并采取了感染控制措施。对不同年份的FP周期特征和结果进行了比较。2020年的周期数量比2019年增加了近30%(27个 vs. 19个)。两组患者的诊断、年龄和抗苗勒管激素水平相似。与2019年相比,2020年选择胚胎冷冻保存而非卵母细胞冷冻保存的患者更多(45.8% vs. 5.2%,P < 0.005)。在新冠疫情期间接受治疗的患者监测访视次数更少(5 ± 1次 vs. 6 ± 1次,P = 0.02),37.5%的周期采用了盲法触发注射。卵巢刺激的总天数没有差异(11 ± 1天 vs. 11 ± 2天,P > 0.05),但2020年的周期使用了更多的促性腺激素(4770 ± 1480单位 vs. 3846 ± 1438单位,P = 0.04)。每个周期回收的总卵母细胞数量(19 ± 14个 vs. 22 ± 12个,P > 0.05)或玻璃化的成熟卵母细胞数量(15 ± 12个 vs. 17 ± 9个,P > 0.05)没有差异。在新冠疫情期间FP治疗仍在继续,2020年完成的周期比2019年更多。尽管监测最少,但结果是最佳的,且与历史对照相当,这表明FP护理可以在不影响结果的情况下进行调整。