供卵者接种 mRNA COVID-19 疫苗是否会影响受者的卵巢刺激参数或 IVF 结局？

Does mRNA COVID-19 vaccination in oocyte donors impact ovarian stimulation parameters or IVF outcomes for recipients?

机构信息

Department of Reproductive Medicine, Instituto Bernabeu, Cartagena, Spain.

Department of Reproductive Medicine, Accuna, Alicante, Spain.

出版信息

Reprod Biomed Online. 2023 Apr;46(4):697-704. doi: 10.1016/j.rbmo.2023.01.002. Epub 2023 Jan 11.

DOI:10.1016/j.rbmo.2023.01.002

PMID:36803967

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9831660/

Abstract

RESEARCH QUESTION

What is the effect of mRNA severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccination in young oocyte donors in terms of ovarian response to stimulation, fertilization rate, embryo development and clinical outcomes in recipients?

DESIGN

This retrospective, multicentre cohort study evaluated 115 oocyte donors who had undergone at least two ovarian stimulation protocols (before and after complete SARS-CoV-2 vaccination) between November 2021 and February 2022. Comparisons were made of the primary outcomes of days of stimulation, total dose of gonadotrophins and laboratory performance in ovarian stimulation in oocyte donors before and after vaccination. A total of 136 cycles in matched recipients were analysed as secondary outcomes and, from those, 110 women received a fresh single-embryo transfer, with analysis of biochemical β-human chorionic gonadotrophin concentrations and rates of clinical pregnancy with heartbeat.

RESULTS

Longer stimulation was required in the post-vaccination than pre-vaccination group (10.31 ± 1.5 versus 9.51 ± 1.5 days; P < 0.001) along with higher gonadotrophin consumption (2453.5 ± 740 versus 2235.5 ± 615 IU; P < 0.001) with a similar starting dose of gonadotrophins in both groups. More oocytes were retrieved in the post-vaccination group (16.62 ± 7.1 versus 15.38 ± 7.0; P = 0.02). However, the number of metaphase II (MII) oocytes was similar between groups (pre-vaccination 12.61 ± 5.9 versus post-vaccination 13.01 ± 6.6; P = 0.39) and the ratio of MII/retrieved oocytes favoured the pre-vaccination group (0.83 ± 0.1 versus 0.77 ± 0.2 post-vaccination; P = 0.019). In recipients with a similar number of provided oocytes, the fertilization rate, total number of obtained blastocysts, number of top-quality blastocysts, and rates of biochemical pregnancy and clinical pregnancy with heartbeat were not significantly different between groups.

CONCLUSIONS

This study shows no adverse influence of mRNA SARS-CoV-2 vaccination on ovarian response in a young population.

摘要

研究问题

在接受者中，mRNA 严重急性呼吸综合征冠状病毒 2 (SARS-CoV-2) 疫苗接种对年轻卵母细胞供体的卵巢刺激反应、受精率、胚胎发育和临床结局有何影响？

设计

这项回顾性、多中心队列研究评估了 115 名卵母细胞供体，她们在 2021 年 11 月至 2022 年 2 月期间至少进行了两次卵巢刺激方案（接种前和完全接种 SARS-CoV-2 疫苗后）。比较了疫苗接种前后卵母细胞供体卵巢刺激的主要结局，包括刺激天数、促性腺激素总剂量和实验室表现。作为次要结局，对 136 个匹配接受者的周期进行了分析，其中 110 名妇女接受了新鲜的单个胚胎移植，并分析了生化β-人绒毛膜促性腺激素浓度和有心跳的临床妊娠率。

结果

与接种前相比，接种后组需要更长的刺激时间（10.31 ± 1.5 天对 9.51 ± 1.5 天；P < 0.001），促性腺激素消耗也更高（2453.5 ± 740 国际单位对 2235.5 ± 615 国际单位；P < 0.001），但两组的起始促性腺激素剂量相似。接种后组获得的卵母细胞数量更多（16.62 ± 7.1 个对 15.38 ± 7.0 个；P=0.02）。然而，两组的中期 II (MII) 卵母细胞数量相似（接种前 12.61 ± 5.9 个对接种后 13.01 ± 6.6 个；P=0.39），并且 MII/回收卵母细胞的比例有利于接种前组（0.83 ± 0.1 对 0.77 ± 0.2 接种后；P=0.019）。在接受者提供的卵母细胞数量相似的情况下，两组的受精率、获得的总胚胎数、优质胚胎数以及生化妊娠率和有心跳的临床妊娠率均无显著差异。