SARS-CoV-2 infection is detrimental to pregnancy outcomes after embryo transfer in IVF/ICSI: a prospective cohort study

Abstract

Abstract Background To explore whether SARS-CoV-2 infection affects the pregnancy outcomes of assisted reproductive techniques (ART). Methods A prospective cohort study recruited patients for embryo transfer from December 01, 2022, to December 31, 2022. All patients were closely followed up for SARS-CoV-2 infection after embryo transfer. The SARS-CoV-2 “diagnosed group” was defined as RNA or antigen-positive. The SARS-CoV-2 “suspected infection group” was defined as having apparent SARS-CoV-2 symptoms without an RNA or antigen test, while the “uninfected group” was defined as having a negative SARS-CoV-2 RNA or antigen test and no SARS-CoV-2 symptoms. Results A total of 1330 patients participated in the study, 687 of whom were in the SARS-CoV-2 diagnosed group, 219 in the suspected infection group, and 424 in the uninfected group. There was no significant difference in basic characteristics among the three groups. The clinical pregnancy rate was 68% in the SARS-CoV-2 diagnosed group, 63% in the uninfected group, and 51% in the suspected infection group (P < 0.001). The ongoing pregnancy rate was 58% in the SARS-CoV-2 diagnosed group, 53% in the uninfected group, and 45% in the suspected infection group (P < 0.001). Upon analyzing the factors influencing clinical pregnancy, it was found that suspected infection (odds ratio [OR] 0.618, 95% CI 0.444–0.862, P = 0.005) and the short time (≤ 22 days) between embryo transfer and SARS-CoV-2 infection (OR 3.76, 95% CI 1.92–8.24, P < 0.001) were not conducive to clinical pregnancy. In addition, the concurrent presence of fever and dizziness/headache SARS-CoV-2 symptoms (OR 0.715, 95% CI 0.526–0.972, P = 0.032) decreased the clinical pregnancy rate. However, vaccination administered 2–3 times (OR 1.804, 95% CI 1.332–2.444, P < 0.001) was associated with an improvement in clinical pregnancy rate. Conclusions This prospective cohort study shows that SARS-CoV-2 infection in a short period of time after embryo transfer is not conducive to clinical pregnancy. Reproductive physicians should advise patients to avoid SARS-CoV-2 infection shortly after embryo transfer. Meanwhile, women should be encouraged to vaccinate at least 2–3 times before embryo transfer or pregnancy.

Keywords

• SARS-CoV-2 infection
• Embryo transfer
• IVF/ICSI
• Pregnancy outcomes