Banker Manish, Arora Parul, Banker Jwal, Shah Anand, Gupta Reena, Shah Sandeep
Department of Reproductive Medicine, Nova IVF Fertility, Ahmedabad, Gujarat, India.
Department of Medicine, Unit 1, SVP General Hospital, Ahmedabad, Ahmedabad, Gujarat, India.
J Hum Reprod Sci. 2022 Apr-Jun;15(2):150-156. doi: 10.4103/jhrs.jhrs_57_22. Epub 2022 Jun 30.
The emergence of the COVID pandemic unfolded a series of precautions and dilemmas and the complete suspension of health services. With the gradual emergence of data showing near minimal effects of the virus on pregnancy, Assisted Reproductive Techniques (ART) services were gradually resumed following guidelines and advisories.
The purpose of this study was to detect the COVID positivity rate in women undergoing ART treatment during the COVID pandemic and compare clinical and embryological outcomes to the ART cycles performed in the pre-COVID era.
This was a retrospective cohort study of all women undergoing controlled ovarian stimulation, followed by a fresh or frozen embryo transfer (ET) between 1st October 2019 and 31st March 2020 (control group) and between 1st April 2020 and 31st September 2020 (study group) at Nova IVF Fertility Clinic, Ahmedabad.
The study group underwent ART during the first wave of COVID-19 pandemic in India and when gradual unlocking of facilities including ART was advised as per the national ART advisory by the ICMR in December 2020. The outcomes were compared with the control group (cycles in pre-covid time).
Statistical analysis was performed in SPSS (v25.0) and included Mann-Whitney U, Fisher's exact and Pearson Chi-square as appropriate. Values of < 0.05 were considered statistically significant.
A total of 367 fertilisation (IVF) stimulations were initiated. A total of 342 retrievals and 606 ETs (171 fresh and 435 frozen) were completed during the study period with a COVID positivity rate of 6.8% (25/367) amongst fresh and 3.9% (18/453) amongst frozen ETs, respectively; the PR and IR in the study group was similar to the control group (47.6 vs. 55.1 = 0.4 and 68.7 vs. 66.4; = 0.52, respectively). The maternal complication rates were similar in both groups with a COVID positivity rate of 10.2% (23/225) and 1 maternal death in the study group. The live birth rates were similar.
We did not find a noteworthy difference in the clinical and embryological outcomes in the IVF cycles conducted in the COVID era as compared to the pre-COVID time. Thus, with adequate precautions and safety measures, ART services conducted during the COVID pandemic have comparable birth outcomes and can be safely advocated.
新冠疫情的出现带来了一系列预防措施和困境，导致医疗服务全面暂停。随着数据逐渐显示该病毒对妊娠的影响几乎微乎其微，辅助生殖技术（ART）服务在遵循指南和建议的情况下逐渐恢复。
本研究的目的是检测新冠疫情期间接受ART治疗的女性的新冠病毒阳性率，并将临床和胚胎学结果与新冠疫情前时期进行的ART周期进行比较。
这是一项回顾性队列研究，研究对象为2019年10月1日至2020年3月31日（对照组）以及2020年4月1日至2020年9月31日（研究组）在艾哈迈达巴德的Nova IVF生育诊所接受控制性卵巢刺激，随后进行新鲜或冷冻胚胎移植（ET）的所有女性。
研究组在印度新冠疫情第一波期间接受ART治疗，当时根据ICMR于2020年12月发布的国家ART咨询建议，包括ART在内的设施逐步解封。将结果与对照组（新冠疫情前时期的周期）进行比较。
在SPSS（v25.0）中进行统计分析，根据情况包括Mann-Whitney U检验、Fisher精确检验和Pearson卡方检验。P值<0.05被认为具有统计学意义。
共启动了367次受精（IVF）刺激。在研究期间共完成了342次取卵和606次胚胎移植（171次新鲜移植和435次冷冻移植），新鲜胚胎移植中的新冠病毒阳性率为6.8%（25/367），冷冻胚胎移植中的阳性率为3.9%（18/453）；研究组的临床妊娠率（PR）和着床率（IR）与对照组相似（分别为47.6%对55.1%，P = 0.4；68.7%对66.4%，P = 0.52）。两组的母体并发症发生率相似，研究组的新冠病毒阳性率为10.2%（23/225），有1例孕产妇死亡。活产率相似。
我们发现，与新冠疫情前时期相比，新冠疫情期间进行的IVF周期在临床和胚胎学结果方面没有显著差异。因此，通过充分的预防措施和安全措施，新冠疫情期间开展的ART服务具有可比的分娩结果，可以安全地推广。
