SARS-CoV-2 within 10 weeks after embryo transfer does not impact IVF/ICSI treatment

Key takeaways:

• SARS-CoV-2 infection had no significant tie to biochemical pregnancy, implantation or clinical pregnancy rates.
• Within 10 weeks post-embryo transfer, SARS-CoV-2 had no significant tie to early miscarriage rates.

For women using IVF/intracytoplasmic sperm injection, SARS-CoV-2 infection within 10 weeks after embryo transfer may not negatively affect pregnancy, implantation and miscarriage rates, researchers reported.

“In December 2022, China faced a notable surge in SARS-CoV-2 infections, affecting nearly a billion individuals, primarily attributed to the BA.5 and BF.7 omicron subvariants. This surge coincided with the termination of the ‘Zero-COVID’ policy, a decision predicated on the presumed reduction in virulence owing to the evolving nature of the virus and widespread vaccination,” Xue-Fei Li, MD, from The Reproductive Center at Sichuan Jinxin Xinan Women and Children’s Hospital, Sichuan, China, and colleagues wrote. “Amidst this situation, IVF centers observed a rise in the number of infected patients, providing an opportunity to explore the association between SARS-CoV-2 infection post-embryo transfer and early pregnancy outcomes in female patients undergoing IVF/intracytoplasmic sperm injection-embryo transfer therapy.”

Li and colleagues conducted a prospective cohort study with data from 857 women aged 20 to 29 years who underwent IVF/intracytoplasmic sperm injection (ICSI) at a single public IVF center in China. Researchers tracked SARS-CoV-2 infection in the cohort at 14 days or less, 28 days or less and 10 weeks or less after embryo transfer, as well as symptoms, vaccination status, time between vaccination and embryo transfer, and early pregnancy outcomes.

Primary outcomes were rates of biochemical pregnancy, embryo implantation, clinical pregnancy and early miscarriage.

Results, published in the American Journal of Obstetrics and Gynecology, demonstrated that SARS-CoV-2 infection within the first 14 days after embryo transfer was not significantly negatively associated with biochemical pregnancy rates between infected (58.1%) and uninfected women (65.9%; adjusted OR = 0.74; 95% CI, 0.51-1.09). Within 28 days after embryo transfer, between infected and uninfected women, SARS-CoV-2 infection also had no significant association with embryo implantation rates (infected, 36.6% vs. uninfected, 44%) and clinical pregnancy rates (infected, 49.1% vs. uninfected, 58.2%; aOR = 0.69; 95% CI, 0.56-1.09).

Finally, within 10 weeks after embryo transfer, SARS-CoV-2 infection had no significant association with early miscarriage rates for infected (8.8%) vs. uninfected women (9.3%; aOR = 0.77; 95% CI, 0.35-1.71).

“This information offers valuable insights, addressing current concerns and providing a clearer understanding of the actual risk associated with SARS-CoV-2 infection after embryo transfer in IVF/ICSI,” the researchers wrote.