P-710 COVID-19 Vaccination and Infertility Treatment Outcomes

Abstract

Study question Is there an influence of mRNA COVID-19 vaccine on ovarian response and in vitro fertilization (IVF) treatment outcomes? Summary answer COVID-19 mRNA vaccine did not affect the ovarian response nor pregnancy rates in IVF treatment What is known already Studies demonstrated that infection with COVID-19 during pregnancy increased the risk of the development of severe disease and pregnancy complications. A recent meta-analysis of international data showed a declining tendency to be vaccinated, possibly influenced by public concerns over safety of the vaccines. Specifically, concerns were raised about a possible detrimental effect on fertility and pregnancy outcomes due to similarity between syncytin-1, a human placental fusion protein, and the SARS-CoV-2 spike protein expressed after administration of the COVID-19 vaccine. To date, only one retrospective analysis on 36 infertility patients has assessed the influence of COVID-19 vaccination on IVF treatment outcomes. Study design, size, duration A retrospective cohort study . The study included a total of 400 patients, 200 vaccinated women and 200 age matched non-vaccinated women, undergoing IVF treatments during January-April 2021. Participants/materials, setting, methods All vaccinated women aged 20-42 that underwent IVF treatment cycles between January 1, 2021 and April 31 2021 were included. All participants completed two doses of the BNT162b2 (Pfizer-BioNTech) vaccine at least two weeks before starting ovarian stimulation. The study group was matched by age to non-vaccinated patients that underwent IVF treatments during the same period. Patients with a positive COVID 19 test in the past were excluded. Main results and the role of chance Two hundred patients underwent oocyte retrieval 14-68 days after receiving COVID-19 vaccination. No difference was found between vaccinated and non-vaccinated patients in mean number of oocytes retrieved per cycle (10.63 vs 10.72, p = 0.93). Among 128 vaccinated patients and 133 non-vaccinated patients that underwent fresh embryos transfers, no difference was demonstrated in clinical pregnancy rates (32.8% vs. 33.1%, p-value=0.96), 42 and 44 pregnancies respectively. The fertilization rates and mean number of cryopreserved embryos were similar between the two groups in freeze all cycles (55.43% vs. 54.29%, p-value=0.73), (3.59 vs. 3.28, p-value=0.80). Among vaccinated patients and non-vaccinated patients that underwent fresh embryos transfers, no difference was demonstrated in the fertilization rate (64.81% vs. 61.98%, p = 0.51), and transferred embryos quality. Regression models applied demonstrated no effect of the vaccine on oocyte yields and pregnancy rates. Limitations, reasons for caution Limitations include retrospective nature and different treatment protocols. Additional limitation is the lack of information about vaccination status of the partners. One would assume that if unbalanced, the proportion of vaccinated males would be higher in the study group as partners tend to choose similarly in regard to vaccine administration. Wider implications of the findings Women should consider vaccination prior to their attempts to conceive via IVF treatments. Trial registration number ASF-0094-21

Coronavirus Disease 2019 (COVID-19) Vaccination and Assisted Reproduction Outcomes

“…Two studies provided median and interquartile range data. 38,40 Attempts to contact the authors to solicit the mean and SD from their study data were unsuccessful; therefore, the mean and SD were derived from the median and range using the formula developed by Wan et al 15 Two studies reported mean and 95% CI data 19,22 ; the SDs for these were derived using the method outlined by the Cochrane Handbook. 16 Seventeen studies reported data on our primary outcome (positive b-hCG and presence of a gestational sac on ultrasonography), with no significant differences between the vaccinated and unvaccinated patients across these studies (mean rate 52.6% and 57.2%, respectively), and an aggregated OR of 0.94 and 95% CI of 0.88-1.01 (P5.10).…”

“…Of these, 14 were conference abstracts and one was not available in English, leaving 25 original studies for inclusion in the final analysis. 19–43 A flow diagram representation of this methodology is shown in Figure 1.…”

Effect of COVID-19 vaccination on the outcome of in vitro fertilization: A systematic review and meta-analysis

“…We also analyzed data on whether COVID-19 vaccines affected the number of oocytes and MII/mature oocytes, blastocysts rate, and fertilization rate. Data on the number of oocytes from nine studies (18,19,22,(24)(25)(26)(27)(28)33) were combined, and the difference was not statistically significant (MD: 0.12; 95% CI: −0.65-0.88; P = 0.77; Figure 6). Moreover, there was no statistically significant difference in the number of MII/mature oocytes between the vaccinated and unvaccinated groups from seven studies (MD: 0.27; 95% CI: −0.36-0.90; P = 0.40; Figure 7) (18-20, 25, 26, 28, 33).…”

“…Quality assessment NOS quality assessment scored more than or equal to 7 as high quality, 5-6 as medium quality, and <5 as low quality (38). Overall, 19 of the 20 cohort studies (18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(32)(33)(34)(35)(36)(37) were of high quality (NOS score ≥7). The remaining study (31) was of relatively poor quality, as summarized in Table 2.…”

Coronavirus disease 2019 vaccine and in vitro fertilization outcomes: myths vs. facts

“…The investigators did not find a difference in the oocyte fertilization rate and mean number of cryopreserved embryos at both cleavage and blastocyst stages. In addition, for those who underwent fresh embryo transfers, the clinical pregnancy rates were comparable between the vaccinated and unvaccinated participants (4).…”