#71 : Successful IVF Procedure on SARS-CoV-2 Positive Advance Maternal Age Woman

Abstract

Background and Aims: Due to the coronavirus disease-19 (COVID-19) pandemic, assisted reproductive techniqueservices across Indonesia have been suspended. With an unpredictable duration, the suspension is affecting particular groups of women who want to achieve pregnancy, including advanced aged women whose fertility has declined significantly. Here we present a 44-year-old woman with primary infertility and nulliparous with unexplained indication who underwent an in vitro fertilization procedure while confirmed positive for COVID-19. The goal of this study was to investigate SARS-CoV-2 transmission through the embryo and its effect on the embryo survival rate. Method: The IVF procedure was carried out following standard methods. Controlled ovarian stimulation was done by giving growth hormone and exogenous gonadotropin on the first day of the cycle, gonadotropin-releasing hormone antagonist on day 7 of the cycle, and human chorionic gonadotropin 36 hours before ovum pick up. Then, ovum pick up was carried out with COVID-19 standard safety procedures and the follicles were sent to the IVF laboratory with a heating stage. The oocytes were obtained from the follicular fluid analysis, following intracytoplasmic sperm injection. The zygotes were cultured for 48 hours and tested negative for SARS-CoV-2. Afterward, the entire embryos were vitrified for 30 days until the patient’s RT-PCR test confirmed negative for SARS-CoV-2 infection. Thereafter, an endometrial thickness examination was done, followed by embryo transfer on the same day. Results: Six oocytes in metaphase-II were retrieved while the patient was confirmed positive with COVID-19. After fertilization, 6 embryos were obtained, tested negative for COVID-19, and were later vitrified. Conclusion: Two of the embryos survived vitrification and both were successfully transferred. IVF with standard procedures is safe to proceed on COVID-19 positive women.