SARS-CoV-2 infection, vaccination and in vitro fertilization treatment: A prospective cohort study

Xudong Zhang; Xinyao Li; Wanmeng Chen; Shanshan Wu; Xiaohan Qi; Jiansu Bian; Shan Gao; Yimeng Lu; Jichun Tan

doi:10.1016/j.intimp.2024.112291

SARS-CoV-2 infection, vaccination and in vitro fertilization treatment: A prospective cohort study

Int Immunopharmacol. 2024 May 20:135:112291. doi: 10.1016/j.intimp.2024.112291. Online ahead of print.

Authors

Xudong Zhang¹, Xinyao Li¹, Wanmeng Chen¹, Shanshan Wu¹, Xiaohan Qi¹, Jiansu Bian¹, Shan Gao¹, Yimeng Lu¹, Jichun Tan²

Affiliations

¹ Centre of Reproductive Medicine, Department of Obstetrics and Gynaecology, Shengjing Hospital of China Medical University, No. 39 Huaxiang Road, Tiexi District, Shenyang, Liaoning 110022, PR China; Key Laboratory of Reproductive Dysfunction Disease and Fertility Remodelling of Liaoning Province, Shenyang, Liaoning 110022, PR China.
² Centre of Reproductive Medicine, Department of Obstetrics and Gynaecology, Shengjing Hospital of China Medical University, No. 39 Huaxiang Road, Tiexi District, Shenyang, Liaoning 110022, PR China; Key Laboratory of Reproductive Dysfunction Disease and Fertility Remodelling of Liaoning Province, Shenyang, Liaoning 110022, PR China. Electronic address: tjczjh@163.com.

PMID: 38772300
DOI: 10.1016/j.intimp.2024.112291

Abstract

Background: The impact of COVID-19 on reproductive health is controversial. The association between female SARS-CoV-2 infection and laboratory and pregnancy outcomes following subsequent in vitro fertilization (IVF) treatment remains unclear. This study aimed to investigate the relationship between IVF treatment at different time intervals after SARS-CoV-2 infection and reproductive outcomes.

Methods: A prospective cohort study of 920 IVF cycles post-SARS-CoV-2 infection was conducted. Modified Poisson regression and logistic regression models were utilized to evaluate oocyte- and embryo-related outcomes as well as clinical outcomes. Stratified analyses were also performed based on the vaccination status of the female participants.

Results: SARS-CoV-2 infection within three months was associated with reduced available [Adjusted RR (aRR): 0.96, 95 %CI: 0.91-1.00] and top-quality embryos (aRR: 0.90, 95 %CI: 0.83-0.98) in subsequent IVF treatment. Among patients failing to finish the three-dose vaccination, the interval between SARS-CoV-2 infection and cycle initiation of less than 90 days was associated with a lower number of oocytes retrieval (aRR: 8.81, 95 %CI: 8.24-9.41 vs aRR: 9.64, 95 %CI: 9.06-10.25), available embryos (aRR: 0.93, 95 %CI: 0.88-0.99), and top-quality embryos (aRR: 0.81, 95 %CI: 0.72-0.91) rather than among fully vaccinated women. Moreover, COVID-19 infection was not associated with biochemical pregnancy, clinical pregnancy, embryo implantation, and early abortion either in fresh embryo transfer (ET) or frozen ET.

Conclusions: This study indicated that initiating IVF treatment within 90 days of SARS-CoV-2 infection might reduce the likelihood of obtaining available and top-quality embryos, especially among those who had not completed the three-dose vaccination. Nevertheless, female COVID-19 infection did not affect pregnancy or early abortion. Further rigorously designed studies are required to support these findings.

Keywords: COVID-19; Embryo; In vitro fertilization; SARS-CoV-2; Vaccination.