Universal SARS-CoV-2 polymerase chain reaction screening and assisted reproductive technology in a coronavirus disease 2019 pandemic epicenter: screening and cycle outcomes from a New York City fertility center

Abstract

Objective(s) To evaluate the prevalence of COVID-19 and efficacy of a universal screening program in patients undergoing controlled ovarian stimulation (COS) Design Single center retrospective cohort study Setting Academic fertility center in New York City, the epicenter of the COVID-19 pandemic Patients All patients undergoing controlled ovarian stimulation from June 17, 2019 to February 28, 2021 Intervention Universal COVID-19 screening starting June 17, 2020 with SARS-CoV-2 PCR testing within five days of oocyte retrieval, patient-reported symptoms screen and temperature monitoring Main Outcomes Measure(s) The primary outcome was the number of positive COVID-19 cases in patients undergoing controlled ovarian stimulation cycles. The secondary outcomes were cycle outcomes compared to pre-COVID-19 COS cycles, adverse outcomes in COVID-canceled cycles, and the center-specific COVID-19 detection rates compared to New York City cases. Results From June 17, 2020 to February 28, 2021, 1,696 controlled ovarian stimulation cycles were initiated with only 7 positive COVID-19 cases for an overall positivity rate of 0.4%. When compared to pre-COVID cycles from June 17, 2019 to February 28, 2020, the volume of COS cycles was higher, while the overall cycle cancellation rate was lower during COVID-19. Cycle outcomes including oocyte yield and blast utilization rates were unchanged from pre-COVID cycles. Cases of COVID-19, while very low, occurred more frequently during surges in New York City rates. Conclusion(s) Assisted Reproductive Technology can be performed during the COVID-19 pandemic utilizing frequent universal screening and safe practices with low SARS-CoV-2 positivity, low cycle cancellation rates, and positive patient outcomes.

The COVID-19 Pandemic Impact on the Outcome of Medically Assisted Reproduction Pregnancies

“…It is possible that patients with ART, in order to optimize the pregnancy outcomes, tend to create a "Secured-Bubble, " to self-isolate themselves and to avoid potential risks. In accordance, a recent retrospective US study found a very low incidence of SARS-Cov-2 infection among patients with ART (26).…”

COVID-19 infection control protocol and acceptance in an ART in vitro fertilization hospital

“…During the pandemic, one ART Hospital in New York performed screening on all 1700 of its patients, with 7 patients testing positive for the virus. A low positivity rate serves to show that ART treatment under the pandemic is sufficiently viable [ 6 ]. In practice, the probability of severe COVID-19 infection amongst women of reproductive age is lower than that of males as well as women of other age groups [ 7 ].…”

Oocyte Retrieval in Asymptomatic Patients Positive for SARS-CoV-2

“…All six patients who tested positive prior to retrieval had their cycles cancelled. No complications, such as ovarian hyperstimulation syndrome (OHSS), occurred in these six women [4].…”

“…Frequent follow-up by phone with the patient to assess for symptoms and need for further evaluation or treatment. 4 Case Reports in Obstetrics and Gynecology consideration, especially during the COVID-19 pandemic. Leukemia, breast cancer, endometrial cancer, and cervical cancer are just a few malignancies that impact reproductive age women, highlighting the importance of counseling and offering timely fertility preservation options for those who…”