目的:本研究旨在探讨COVID-19感染对冷冻胚胎移植(FET)女性胚胎着床和早期发育的潜在影响,特别关注FET周围不同时期发生的感染。
方法:对上海地区在COVID-19感染显著激增的期间行FET的女性进行回顾性分析。所有登记的女性在FET发生时经历了他们第一次记录的COVID-19感染,确保在取卵前不发生感染.根据感染时间将参与者分为六组:未感染,≥60天,FET前<60天,0-14天,15-28天,和FET后29-70天。比较了这些组的临床结果。
结果:709例患者中感染率为78.28%。受感染的个体表现出无症状或轻度症状。前四组的持续妊娠率为40.7%,44.4%,40.5%,和34.2%(P=0.709),生化妊娠率(59.1%vs.61.1%vs.67.6%与55.7%,P=0.471)和临床妊娠率(49.6%vs.55.6%与55.4%vs.48.1%,P=0.749),均无显著差异。所有六组的早期自然流产率为18.3%,20.0%,25.0%,28.9%,5.4%,和19.0%,差异无统计学意义(P=0.113)。多变量逻辑分析显示感染与持续妊娠之间没有显着相关性。
结论:FET周围发生的无症状或轻度COVID-19感染似乎不会对早期妊娠结局产生重大不利影响。
OBJECTIVE: The study aimed to investigate the potential influence of COVID-19 infection on embryo implantation and early development in women undergoing frozen embryo transfer (FET), with a specific focus on infections occurring at different periods around FET.
METHODS: A retrospective analysis was performed on women who had undergone FET during a period marked by a significant surge in COVID-19 infection in Shanghai. All enrolled women experienced their first documented COVID-19 infection around the time of FET, ensuring that infections did not occur prior to oocyte retrieval. Participants were categorized into six groups based on the timing of infection: uninfected, ≥ 60 days, < 60 days before FET, 0-14 days, 15-28 days, and 29-70 days after FET. Clinical outcomes were compared across these groups.
RESULTS: The infection rate among the total of 709 cases was 78.28%. Infected individuals exhibited either asymptomatic or mild symptoms. The ongoing pregnancy rates for the first four groups were 40.7%, 44.4%, 40.5%, and 34.2% (P = 0.709) respectively, biochemical pregnancy rates (59.1% vs. 61.1% vs. 67.6% vs. 55.7%, P = 0.471) and clinical pregnancy rates (49.6% vs. 55.6% vs. 55.4% vs. 48.1%, P = 0.749), all showed no significant differences. Early spontaneous abortion rates across all six groups were 18.3%, 20.0%, 25.0%, 28.9%, 5.4%, and 19.0% respectively, with no significant differences (P = 0.113). Multivariable logistic analysis revealed no significant correlation between the infection and ongoing pregnancy.
CONCLUSIONS: Asymptomatic or mild COVID-19 infections occurring around FET do not appear to have a significant adverse impact on early pregnancy outcomes.