目的:冻融胚胎移植(FET)周期中的严重急性呼吸道综合征冠状病毒2(SARS-CoV-2)感染是否会影响胚胎植入和妊娠率?
结论:没有证据表明FET周期中女性的SARS-CoV-2感染会对胚胎植入和妊娠率产生负面影响。
背景:2019年冠状病毒病(COVID-19),作为一种多系统的疾病,对生殖健康构成威胁。然而,SARS-CoV-2感染对生育治疗后胚胎植入和妊娠的影响,特别是FET,基本上是未知的。
方法:这项回顾性队列研究,包括在2022年11月1日至2022年12月31日期间在学术生育中心接受FET周期的女性.
方法:在FET周期中SARS-CoV-2检测呈阳性的女性被纳入COVID-19组,而在同一研究期间检测阴性的人被纳入非COVID-19组。主要结果是持续妊娠率。次要结果包括植入率,生化妊娠,临床妊娠,早期妊娠丢失,和持续怀孕。应用多变量逻辑回归模型来调整潜在的混杂因素,包括年龄,身体质量指数,妊娠,疫苗接种状况,和子宫内膜准备方案。亚组分析是根据感染时间相对于转移进行的(转移前,转移后1-7天,或转移后8-14天)和发烧水平(无发烧,发烧<39°C,或发烧≥39°C)。
结果:共有243名和305名妇女被纳入COVID-19和非COVID-19组,分别。生化妊娠率(58.8%vs62.0%,P=0.46),临床妊娠(53.1%vs54.4%,P=0.76),植入(46.4%vs46.2%,P=0.95),早期妊娠丢失(24.5%vs26.5%,P=0.68),和持续怀孕(44.4%vs.45.6%,P=0.79)在有或没有感染的组之间都具有可比性。逻辑回归模型的结果,调整前后,发现SARS-CoV-2感染与生化妊娠率之间没有关联,临床妊娠,早期妊娠丢失,或正在怀孕。此外,与转移有关的感染时间(转移前,转移后1-7天,或转移后8-14天)或发烧水平(无发烧,发烧<39°C,或发烧≥39°C)被发现与怀孕率有关。
结论:本研究的回顾性性质可能存在选择偏倚。此外,尽管COVID-19组的样本量相对较大,某些子组的样本量相对较小,缺乏足够的能力,因此,这些结果应谨慎解释。
结论:研究结果表明,女性FET周期中的SARS-CoV-2感染不会影响胚胎植入和妊娠率,包括生化妊娠,临床妊娠,早期妊娠丢失,持续怀孕,这表明SARS-CoV-2感染可能没有必要取消周期。需要进一步的研究来验证这些发现。
背景:本研究得到了国家重点研究发展计划(2023YFC2705500,2019YFA0802604)的支持,国家自然科学基金(82130046,82101747),上海领军人才计划,上海地方高水平大学创新研究团队(SHSMU-ZLCX20210201,SHSMU-ZLCX20210200,SSMU-ZLCX20180401),上海交通大学医学院附属仁济医院临床研究创新培育基金项目(RJPY-DZX-003),上海市科学技术委员会(23Y11901400),上海帆船项目(21YF1425000),上海第一优先研究中心建设项目(2023ZZ02002),《上海市加强公共卫生体系建设三年行动计划》(GWVI-11.1-36),上海市教育委员会-高峰临床医学资助(20161413)。作者没有利益冲突要声明。
背景:不适用。
OBJECTIVE: Does severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection during the frozen-thawed embryo transfer (FET) cycle affect embryo implantation and pregnancy rates?
CONCLUSIONS: There is no evidence that SARS-CoV-2 infection of women during the FET cycle negatively affects embryo implantation and pregnancy rates.
BACKGROUND: Coronavirus disease 2019 (COVID-19), as a multi-systemic disease, poses a threat to reproductive health. However, the effects of SARS-CoV-2 infection on embryo implantation and pregnancy following fertility treatments, particularly FET, remain largely unknown.
METHODS: This retrospective cohort study, included women who underwent FET cycles between 1 November 2022 and 31 December 2022 at an academic fertility centre.
METHODS: Women who tested positive for SARS-CoV-2 during their FET cycles were included in the COVID-19 group, while those who tested negative during the same study period were included in the non-COVID-19 group. The primary outcome was ongoing pregnancy rate. Secondary outcomes included rates of implantation, biochemical pregnancy, clinical pregnancy, early pregnancy loss, and ongoing pregnancy. Multivariate logistic regression models were applied to adjust for potential confounders including age, body mass index, gravidity, vaccination status, and endometrial preparation regimen. Subgroup analyses were conducted by time of infection with respect to transfer (prior to transfer, 1-7 days after transfer, or 8-14 days after transfer) and by level of fever (no fever, fever <39°C, or fever ≥39°C).
RESULTS: A total of 243 and 305 women were included in the COVID-19 and non-COVID-19 group, respectively. The rates of biochemical pregnancy (58.8% vs 62.0%, P = 0.46), clinical pregnancy (53.1% vs 54.4%, P = 0.76), implantation (46.4% vs 46.2%, P = 0.95), early pregnancy loss (24.5% vs 26.5%, P = 0.68), and ongoing pregnancy (44.4% vs 45.6%, P = 0.79) were all comparable between groups with or without infection. Results of logistic regression models, both before and after adjustment, revealed no associations between SARS-CoV-2 infection and rates of biochemical pregnancy, clinical pregnancy, early pregnancy loss, or ongoing pregnancy. Moreover, neither the time of infection with respect to transfer (prior to transfer, 1-7 days after transfer, or 8-14 days after transfer) nor the level of fever (no fever, fever <39°C, or fever ≥39°C) was found to be related to pregnancy rates.
CONCLUSIONS: The retrospective nature of the study is subject to possible selection bias. Additionally, although the sample size was relatively large for the COVID-19 group, the sample sizes for certain subgroups were relatively small and lacked adequate power, so these results should be interpreted with caution.
CONCLUSIONS: The study findings suggest that SARS-CoV-2 infection during the FET cycle in females does not affect embryo implantation and pregnancy rates including biochemical pregnancy, clinical pregnancy, early pregnancy loss, and ongoing pregnancy, indicating that cycle cancellation due to SARS-CoV-2 infection may not be necessary. Further studies are warranted to verify these findings.
BACKGROUND: This study was supported by the National Key Research and Development Program of China (2023YFC2705500, 2019YFA0802604), National Natural Science Foundation of China (82130046, 82101747), Shanghai leading talent program, Innovative research team of high-level local universities in Shanghai (SHSMU-ZLCX20210201, SHSMU-ZLCX20210200, SSMU-ZLCX20180401), Shanghai Jiao Tong University School of Medicine Affiliated Renji Hospital Clinical Research Innovation Cultivation Fund Program (RJPY-DZX-003), Science and Technology Commission of Shanghai Municipality (23Y11901400), Shanghai Sailing Program (21YF1425000), Shanghai\'s Top Priority Research Center Construction Project (2023ZZ02002), Three-Year Action Plan for Strengthening the Construction of the Public Health System in Shanghai (GWVI-11.1-36), and Shanghai Municipal Education Commission-Gaofeng Clinical Medicine Grant Support (20161413). The authors have no conflicts of interest to declare.
BACKGROUND: N/A.