Fertility Preservation During the COVID-19 Pandemic: Modified But Uncompromised

Abstract

Purpose: Throughout COVID-19, our clinic remained operational for patients requiring urgent fertility preservation (FP). This study aimed to characterize changes to clinical protocols during the first wave of COVID-19 and compare outcomes to historical controls. Methods: We performed a retrospective cohort study at a university fertility center examining all patients who underwent medically indicated FP cycles during the American Society for Reproductive Medicine (ASRM) COVID-19 Task Force-recommended suspension of fertility treatment (March 17?May 11, 2020) and patients from the same time period in 2019. FP care was modified for safety during the first wave of COVID-19 with fewer monitoring visits and infection control measures. FP cycle characteristics and outcomes were compared across years. Results: The volume of cycles was nearly 30% higher in 2020 versus 2019 (27 vs. 19). Diagnoses, age, and anti-Mullerian hormone were similar between cohorts. More patients elected to pursue embryo cryopreservation over oocyte cryopreservation in 2020 versus 2019 (45.8% vs. 5.2%, p?<?0.005). Patients managed during COVID-19 had fewer monitoring visits (5???1 vs. 6???1, p?=?0.02), and 37.5% of cycles utilized a blind trigger injection. There was no difference in total days of ovarian stimulation (11???1 vs. 11???2, p?>?0.05), but 2020 cycles utilized more gonadotropin (4770???1480 vs. 3846???1438, p?=?0.04). There was no difference in total oocytes retrieved (19???14 vs. 22???12, p?>?0.05) or mature oocytes vitrified (15???12 vs. 17???9, p?>?0.05) per cycle. Conclusions: FP continued during COVID-19, and more cycles were completed in 2020 versus 2019. Despite minimized monitoring, outcomes were optimal and equivalent to historical controls, suggesting FP care can be adapted without compromising outcomes.

Keywords

• cancer
• controlled ovarian hyperstimulation
• COVID-19
• fertility preservation
• reproductive health