Center for Reproductive Medicine, Jiangxi Key Laboratory of Women's Reproductive Health, Jiangxi Maternal and Child Health Hospital, Jiangxi Branch of National Clinical Research Center for Obstetrics and Gynecology, Nanchang Medical College, Nanchang, China.
Department of Clinical Medicine, School of Queen Mary, Nanchang University, Nanchang, China.
Front Endocrinol (Lausanne). 2023 Oct 4;14:1239903. doi: 10.3389/fendo.2023.1239903. eCollection 2023.
The clinical impact of SARS-CoV-2 infection on human reproduction remains controversial. This prospective cohort study aimed to assess the effect of prior female SARS-CoV-2 infection on subsequent fertilization (IVF) outcomes.
A total of 451 women who underwent fresh IVF treatment between December 1, 2022 and April 30, 2023 were included from an academic fertility center. Participants were divided into the infected group if they had a prior COVID-19 history before cycle initiation (n = 252), while the control group were those uninfected (n = 199). The primary outcomes were the number of oocytes retrieved and clinical pregnancy rate after fresh embryo transfer. Multivariate linear and logistic regression analyses were conducted to control for potential confounders.
The number of oocytes retrieved (11.4 ± 8.3 vs. 11.6 ± 7.7; P = 0.457) and clinical pregnancy rate (70.3% vs. 73.7%; P = 0.590) were similar between infected and uninfected groups, with a fully adjusted β coefficient of 0 (95% confidence interval [CI]: -0.14-0.13) and odds ratio of 0.64 (95% CI: 0.20-2.07), respectively. Consistently, the two groups were comparable in cycle characteristics as well as other laboratory and pregnancy parameters. In both subgroup analyses and restricted cubic splines, different post-infection time intervals to IVF cycle initiation showed no significant associations with treatment outcomes.
Prior SARS-CoV-2 infection in females had no adverse influence on subsequent IVF treatment, regardless of the time interval following infection. Our findings provide reassurance for infected women planning for assisted reproduction. Additional prospective cohort studies with larger datasets and longer follow-up are required to confirm the conclusion.
SARS-CoV-2 感染对人类生殖的临床影响仍存在争议。本前瞻性队列研究旨在评估女性 SARS-CoV-2 感染史对随后体外受精（IVF）结局的影响。
本研究共纳入了 2022 年 12 月 1 日至 2023 年 4 月 30 日期间在一家学术生育中心接受新鲜 IVF 治疗的 451 名女性。如果患者在周期开始前有 COVID-19 病史（n = 252），则将其归入感染组，否则归入未感染组（n = 199）。主要结局是新鲜胚胎移植后的获卵数和临床妊娠率。采用多元线性和逻辑回归分析来控制潜在的混杂因素。
感染组和未感染组的获卵数（11.4 ± 8.3 比 11.6 ± 7.7；P = 0.457）和临床妊娠率（70.3%比 73.7%；P = 0.590）相似，完全调整后的 β 系数为 0（95%置信区间 [CI]：-0.14-0.13）和比值比为 0.64（95% CI：0.20-2.07）。同样，两组在周期特征以及其他实验室和妊娠参数方面也无差异。在亚组分析和限制性三次样条中，感染后到 IVF 周期开始的不同时间间隔与治疗结局均无显著关联。
女性感染 SARS-CoV-2 后进行 IVF 治疗不会产生不良影响，无论感染后时间间隔如何。我们的研究结果为计划接受辅助生殖的感染女性提供了信心。需要更多的前瞻性队列研究，包括更大的数据集和更长的随访时间，以证实这一结论。
