Clinical and Experimental Reproductive Medicine

The Korean Society for Reproductive Medicine (대한생식의학회)
권호 표지
DOI QR코드

DOI QR Code

Outcomes of female reproductive performance with assisted reproductive techniques after recent mild to moderate COVID-19 infections: An observational study

  • Ashraf Moini (Department of Obstetrics and Gynecology, Arash Women's Hospital, Tehran University of Medical Sciences) ;
  • Narges Najafpour (Department of Obstetrics and Gynecology, Arash Women's Hospital, Tehran University of Medical Sciences) ;
  • Ladan Kashani (Department of Obstetrics and Gynecology, Arash Women's Hospital, Tehran University of Medical Sciences) ;
  • Maryam Farid-Mojtahedi (Department of Obstetrics and Gynecology, Arash Women's Hospital, Tehran University of Medical Sciences) ;
  • Arezoo Maleki-Hajiagha (Department of Anatomy, School of Medicine, Tehran University of Medical Sciences) ;
  • Afsaneh Tehranian (Department of Obstetrics and Gynecology, Arash Women's Hospital, Tehran University of Medical Sciences) ;
  • Rana Karimi (Department of Obstetrics and Gynecology, Arash Women's Hospital, Tehran University of Medical Sciences)
  • Received : 2023.07.21
  • Accepted : 2023.12.14
  • Published : 2024.09.30
Download PDF
⟨ Previous Next ⟩

Abstract

Objective: The purpose of this study was to evaluate the impact of preimplantation genetic testing for aneuploidy (PGT-A) on clinical outcomes among high-risk patients. Methods: This retrospective study involved 1,368 patients and the same number of cycles, including 520 cycles with PGT-A and 848 cycles without PGT-A. The study participants comprised women of advanced maternal age (AMA) and those affected by recurrent implantation failure (RIF), recurrent pregnancy loss (RPL), or severe male factor infertility (SMF). Results: PGT-A was associated with significant improvements in the implantation rate (IR) and the ongoing pregnancy rate/live birth rate (OPR/LBR) per embryo transfer cycle in the AMA (39.3% vs. 16.2% [p<0.001] and 42.0% vs. 21.8% [p<0.001], respectively), RIF (41.7% vs. 22.0% [p<0.001] and 47.0% vs. 28.6% [p<0.001], respectively), and RPL (45.6% vs. 19.5% [p<0.001] and 49.1% vs. 24.2% [p<0.001], respectively) groups, as well as the IR in the SMF group (43.3% vs. 26.5%, p=0.011). Additionally, PGT-A was associated with lower overall incidence rates of pregnancy loss in the AMA (16.7% vs. 34.3%, p=0.001) and RPL (16.7% vs. 50.0%, p<0.001) groups. However, the OPR/LBR per total cycle across all PGT-A groups did not significantly exceed that for the control groups. Conclusion: PGT-A demonstrated beneficial effects in high-risk patients. However, our findings indicate that these benefits are more pronounced in carefully selected candidates than in the entire high-risk patient population.

Keywords

References

  1. Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet 2020;395:497-506.  https://doi.org/10.1016/S0140-6736(20)30183-5
  2. Guan WJ, Ni ZY, Hu Y, Liang WH, Ou CQ, He JX, et al. Clinical characteristics of coronavirus disease 2019 in China. N Engl J Med 2020;382:1708-20.  https://doi.org/10.1056/NEJMoa2002032
  3. Stanley KE, Thomas E, Leaver M, Wells D. Coronavirus disease-19 and fertility: viral host entry protein expression in male and female reproductive tissues. Fertil Steril 2020;114:33-43.  https://doi.org/10.1016/j.fertnstert.2020.05.001
  4. Da Broi MG, Giorgi VS, Wang F, Keefe DL, Albertini D, Navarro PA. Influence of follicular fluid and cumulus cells on oocyte quality: clinical implications. J Assist Reprod Genet 2018;35:735-51.  https://doi.org/10.1007/s10815-018-1143-3
  5. Dumesic DA, Meldrum DR, Katz-Jaffe MG, Krisher RL, Schoolcraft WB. Oocyte environment: follicular fluid and cumulus cells are critical for oocyte health. Fertil Steril 2015;103:303-16.  https://doi.org/10.1016/j.fertnstert.2014.11.015
  6. Herrero Y, Pascuali N, Velazquez C, Oubina G, Hauk V, de ZunigaI, et al. SARS-CoV-2 infection negatively affects ovarian function in ART patients. Biochim Biophys Acta Mol Basis Dis 2022;1868:166295. 
  7. Harb J, Debs N, Rima M, Wu Y, Cao Z, Kovacic H, et al. SARS-CoV-2, COVID-19, and reproduction: effects on fertility, pregnancy, and neonatal life. Biomedicines 2022;10:1775. 
  8. World Health Organization. WHO COVID-19 dashboard with vaccination data [Internet]. WHO; 2023 [cited 2023 Dec 30]. Available from: https://covid19.who.int 
  9. National Institutes of Health. Coronavirus disease 2019 (COVID-19) treatment guidelines [Internet]. NIH; 2024 [cited 2024 Mar 7]. Available from: https://www.covid19treatmentguidelines.nih.gov/ 
  10. Madenli AA, Gurkan N, Tosun SA. The effect of COVID-19 infection on anti Mullerian hormone. Anatol Curr Med J 2022;4:412-6.  https://doi.org/10.38053/acmj.1167530
  11. Li K, Chen G, Hou H, Liao Q, Chen J, Bai H, et al. Analysis of sex hormones and menstruation in COVID-19 women of child-bearing age. Reprod Biomed Online 2021;42:260-7.  https://doi.org/10.1016/j.rbmo.2020.09.020
  12. Kolanska K, Hours A, Jonquiere L, Mathieu d'Argent E, Dabi Y, Dupont C, et al. Mild COVID-19 infection does not alter the ovarian reserve in women treated with ART. Reprod Biomed Online 2021;43:1117-21.  https://doi.org/10.1016/j.rbmo.2021.09.001
  13. Orvieto R, Segev-Zahav A, Aizer A. Does COVID-19 infection influence patients' performance during IVF-ET cycle?: an observational study. Gynecol Endocrinol 2021;37:895-7.  https://doi.org/10.1080/09513590.2021.1918080
  14. Hu W, Zhu Y, Wu Y, Wang F, Qu F. Impact of COVID-19 pandemic on the pregnancy outcomes of women undergoing assisted reproductive techniques (ARTs): a systematic review and meta-analysis. J Zhejiang Univ Sci B 2022;23:655-65.  https://doi.org/10.1631/jzus.B2200154
  15. Hossein Rashidi B, Bandarian M, Bandarian F, Shahrokh Tehraninejad E, Jafarabadi M. The effect of COVID-19 pandemic on outcome of assisted reproductive technology: a report from a single infertility center. J Family Reprod Health 2022;16:86-92.  https://doi.org/10.18502/jfrh.v16i1.8598
  16. Banker M, Arora P, Banker J, Shah A, Gupta R, Shah S. Impact of COVID-19 pandemic on clinical and embryological outcomes of assisted reproductive techniques. J Hum Reprod Sci 2022;15:150-6.  https://doi.org/10.4103/jhrs.jhrs_57_22
  17. Kabalkin Y, Gil M, Lifshitz E, Moav A, Kabessa M, Jaber S, et al. O-225 Effects of SARS-corona virus 2 on IVF treatment parameters: a cohort study of post COVID-19 patients. Hum Reprod 2021;36(Supplement 1):deab128-049. 
  18. Youngster M, Avraham S, Yaakov O, Landau Rabbi M, Gat I, Yerushalmi G, et al. IVF under COVID-19: treatment outcomes of fresh ART cycles. Hum Reprod 2022;37:947-53.  https://doi.org/10.1093/humrep/deac043
  19. Wang M, Yang Q, Ren X, Hu J, Li Z, Long R, et al. Investigating the impact of asymptomatic or mild SARS-CoV-2 infection on female fertility and in vitro fertilization outcomes: a retrospective cohort study. EClinicalMedicine 2021;38:101013. 
  20. Zhao C, Zhao W. NLRP3 inflammasome: a key player in antiviral responses. Front Immunol 2020;11:211. 
  21. Sandall CF, Ziehr BK, MacDonald JA. ATP-binding and hydrolysis in inflammasome activation. Molecules 2020;25:4572. 
  22. D'Ippolito S, Tersigni C, Marana R, Di Nicuolo F, Gaglione R, Rossi ED, et al. Inflammosome in the human endometrium: further step in the evaluation of the "maternal side". Fertil Steril 2016;105:111-8.  https://doi.org/10.1016/j.fertnstert.2015.09.027
  23. Xie Y, Mirzaei M, Kahrizi MS, Shabestari AM, Riahi SM, Farsimadan M, et al. SARS-CoV-2 effects on sperm parameters: a meta-analysis study. J Assist Reprod Genet 2022;39:1555-63.  https://doi.org/10.1007/s10815-022-02540-x
  24. Kabalkin Y, Bentov Y, Gil M, Beharier O, Jaber S, Moav-Zafrir A, et al. Mild COVID-19 was not associated with impaired IVF outcomes or early pregnancy loss in IVF patients. J Clin Med 2022;11:5265. 
  25. Wang M, Hu J, Huang B, Yang Q, Liu S, Li Z, et al. Investigating the impact of SARS-CoV-2 infection on basic semen parameters and in vitro fertilization/intracytoplasmic sperm injection outcomes: a retrospective cohort study. Reprod Biol Endocrinol 2022;20:46. 
  26. Stigliani S, Massarotti C, Maccarini E, Casciano I, Anserini P, Scaruffi P. P-091 Semen parameters and male reproductive potential are not negatively affected after recovery from COVID-19 disease. Hum Reprod 2022;37(Supplement 1):deac107-087. 
  27. Paik H, Kim SK. Female reproduction and abnormal uterine bleeding after COVID-19 vaccination. Clin Exp Reprod Med 2023;50:69-77. https://doi.org/10.5653/cerm.2023.05925