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感染 SARS-CoV-2 后的辅助生殖:一项单中心队列研究的结果。

Assisted reproduction after SARS-CoV-2-infection: results of a single-center cohort-study.

机构信息

Department of Gynecology and Obstetrics, University Hospital Carl-Gustav-Carus, Technische Universität Dresden, Fetscherstraße 74, 01307, Dresden, Germany.

Institute for Medical Informatics and Biometry, Technische Universität Dresden, Fetscherstraße 74, Dresden, Germany.

出版信息

Arch Gynecol Obstet. 2024 Jan;309(1):305-313. doi: 10.1007/s00404-023-07228-w. Epub 2023 Oct 10.

Abstract

PURPOSE

The effects of SARS-CoV-2 infections on the outcome of assisted reproduction techniques (ART) were studied in a retrospective cohort study.

METHODS

The outcome of 1581 treatment cycles with embryo transfer at a university fertility center in Germany was compared in years before and during the COVID-19 pandemic. For 335 treatment cycles in 2022 a detailed analysis was carried out depending on infection and immunization status of both partners.

RESULTS

ART cycles did not differ in most of the parameters examined between 2018-2022. In spite of comparable clinical pregnancy rates, there was a significantly higher miscarriage rate at 34.6% (27/78) in 2022, compared to 19.7% (29/147) in the pre-pandemic years of 2018-2019 (p = 0.014). In 37.0% of the treatment cycles (124/335) 2022 at least one partner reported a SARS-CoV-2-Infection 6 months before ART, mostly with the virus variant Omicron. Clinical pregnancy rates were lower in cycles without infection. Comparing women with confirmed infection to no infection, a significantly higher risk of miscarriage was seen (62.5% vs. 26.2%, p = 0.009). In treatment cycles of partners with basic immunization against SARS-CoV-2 a statistically significant increase of pregnancy rates was seen comparing to cycles with both unvaccinated partners (p = 0.011).

CONCLUSION

The results indicate a negative impact of SARS-CoV-2-infections up to 6 months on ART treatment, in particular an increased risk of miscarriage. Vaccination was associated with a better outcome of ART treatment.

摘要

目的

本回顾性队列研究旨在探讨 SARS-CoV-2 感染对辅助生殖技术(ART)结局的影响。

方法

比较了德国一所大学生育中心在 COVID-19 大流行前后的 1581 个胚胎移植治疗周期的结局。在 2022 年的 335 个治疗周期中,根据夫妇双方的感染和免疫状况进行了详细分析。

结果

在检查的大多数参数中,2018-2022 年的 ART 周期没有差异。尽管临床妊娠率相当,但 2022 年的流产率明显较高,为 34.6%(27/78),而 2018-2019 年大流行前年份为 19.7%(29/147)(p=0.014)。在 2022 年的 37.0%(124/335)治疗周期中,至少有一方报告在 ART 前 6 个月有 SARS-CoV-2 感染,大多数是感染了奥密克戎变异株。无感染的周期临床妊娠率较低。与无感染的女性相比,确诊感染的女性流产风险明显更高(62.5%对 26.2%,p=0.009)。与双方均未接种疫苗的周期相比,对 SARS-CoV-2 进行基础免疫接种的夫妇的治疗周期中,妊娠率有统计学显著增加(p=0.011)。

结论

结果表明,SARS-CoV-2 感染在 6 个月内对 ART 治疗有负面影响,特别是流产风险增加。接种疫苗与 ART 治疗结局较好相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/32f5/10769908/f44fa6d6ef11/404_2023_7228_Fig1_HTML.jpg

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