Effect of SARS-CoV-2 infection on IVF/ICSI-ET outcomes: A propensity score-matched cohort study

Abstract

Abstract Background: The SARS-CoV-2 virus is continually evolving, and the worldwide epidemic is still ongoing. There is conflicting evidence regarding how SAS-CoV-2 infection affects the outcomes of assisted reproductive technology (ART). The aim of the current study was to investigate whether the outcomes of in vitro fertilization (IVF) treatment were affected during the acute period of SARS-CoV-2 infection or immediately after recovery from COVID-19. Methods: In this retrospective cohort study, SARS-CoV-2-infected couples who underwent IVF treatment at Wuhan Union Hospital within the first three months following the lifting of the pandemic policy in mainland China were propensity-score matched (PSM) to uninfected couples who received IVF during the dynamic COVID-zero policy. Following matching, 358 and 698 patients were assigned to the SARS-CoV-2-infected and uninfected groups, respectively. The laboratory and clinical outcomes of the two groups were compared. Results: The average number of oocytes retrieved, mature oocyte rates, normal fertilization rates, abnormal fertilization rates, and cleavage rates did not differ significantly between the two groups. The blastocyst formation rates were considerably lower in the infected group than in the uninfected group. Stratification by time from SARS-CoV-2 infection to oocyte retrieval (≤ 30, 31-60, 61-90 and ≥90 days) revealed that both blastocyst formation and available blastocyst rates were significantly decreased when oocyte retrieval was performed 31-60 days after SARS-CoV-2 infection. However, after the first embryo transfer cycle, there were no significant differences in the rates of embryo implantation, biochemical pregnancy, clinical pregnancy or early abortion between the two matched cohorts. Conclusion: SARS-CoV-2 infection had no effect on clinical outcomes after the first embryo transfer cycle; however, the blastocyst formation rate was significantly lower in couples who underwent IVF treatment 31-60 days after SARS-CoV-2 infection, indicating that SARS-CoV-2 infection may still impair embryo developmental potential.