IVF Unit, Department of Obstetrics and Gynecology, Shamir Medical Center, 70300, Zerifin, Israel.
Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel.
J Assist Reprod Genet. 2022 Jul;39(7):1565-1570. doi: 10.1007/s10815-022-02517-w. Epub 2022 May 7.
To study the effect of SARS-CoV-2 infection on pregnancy rates in frozen embryo transfer (FET) cycles.
A retrospective cohort study including women under the age of 42 with documented SARS-CoV-2 infection up to 1 year prior to treatment, undergoing FET cycles in the first half of 2021, with transfer of embryos generated prior to the infection. Controls were SARS-CoV-2 non-diagnosed, non-vaccinated women matched by age, number, and day of embryo transfer. Demographic and cycle characteristics and outcomes were compared.
Forty-one recovered women and 41 controls were included. Pregnancy rates were 29% and 49% respectively (p = 0.070). Stratification by time from SARS-CoV-2 infection to transfer into ≤ 60 and > 60 days revealed a difference in pregnancy rates, with women in the COVID group having lower pregnancy rates if infected in proximity to the transfer (21% vs. 55%; p = 0.006). In a logistic regression model, infection was a significant variable (p = 0.05, OR 0.325, 95% CI 0.106-0.998). Logistic regression applied on the subgroup of women infected in proximity to the transfer further strengthened the univariate results, with COVID-19 remaining a significant parameter (p = 0.005, OR 0.072, 95% CI 0.012-0.450).
In FET cycles of patients with past SARS-CoV-2 infection, in which oocytes were retrieved prior to infection, decreased pregnancy rates were observed, specifically in patients who recovered less than 60 days prior to embryo transfer. Pending further studies, in cases of FET cycles with limited number of embryos, postponing embryo transfer for at least 60 days following recovery from COVID-19 might be considered when feasible.
研究 SARS-CoV-2 感染对冷冻胚胎移植（FET）周期妊娠率的影响。
本回顾性队列研究纳入了年龄在 42 岁以下的女性，这些女性在治疗前 1 年内有 SARS-CoV-2 感染史，在 2021 年上半年进行了 FET 周期，胚胎移植是在感染前进行的。对照组为 SARS-CoV-2 未确诊、未接种疫苗的女性，按照年龄、胚胎数量和移植日进行匹配。比较了两组的人口统计学和周期特征及结局。
共纳入 41 名康复女性和 41 名对照组。妊娠率分别为 29%和 49%（p=0.070）。按 SARS-CoV-2 感染到移植的时间分层，分为≤60 天和>60 天两组，发现两组妊娠率存在差异，即如果感染发生在移植附近，COVID 组的妊娠率较低（21%比 55%；p=0.006）。在逻辑回归模型中，感染是一个显著的变量（p=0.05，OR 0.325，95%CI 0.106-0.998）。对接近移植时感染的女性亚组应用逻辑回归进一步强化了单变量结果，COVID-19 仍然是一个显著的参数（p=0.005，OR 0.072，95%CI 0.012-0.450）。
在过去有 SARS-CoV-2 感染史的 FET 周期中，如果在感染前采集了卵子，观察到妊娠率下降，特别是在距离胚胎移植不到 60 天前康复的患者中。在进一步研究之前，在 FET 周期中胚胎数量有限的情况下，当可行时，考虑在 COVID-19 康复后至少 60 天再进行胚胎移植。
