Effect of Sars-cov-2 on Donor Oocyte Quality and Quantity, a Multicenter Retrospective Study.
Condition: Ovarian Reserve; SARS-CoV-2 Infection; Blastocyst
MeSH terms: COVID-19
Study type: Observational

Summary: 
      Purpose: To determine the impact of SARS-CoV-2 infection and immunization on ovarian response
      to controlled ovarian stimulation (COS) and embryo development after in vitro fertilization
      (IVF) Methods: A retrospective multicentric cohort study of 427 oocyte donors was conducted
      between January 1st, 2018 and September 18th, 2022. Patients who recovered from SARS-CoV-2
      infection, vaccinated or non-exposed were included. Demographic, cycle characteristics, and
      laboratory outcomes were compared.
    

Detailed description: 
      This was a multicenter retrospective cohort study performed at the Centro de Fertilidad y
      Genetica Novafem, Bogota, Colombia, and Clinica de la Mujer - Medicina Reproductiva, Viña del
      Mar, Chile. The Ethics Committee approved the study protocol of both centers. Informed
      contents were obtained from patients for data collection with scientific use.

      All donors who underwent COS for oocyte donation between January 1st, 2018 and July 31th,
      2022 were screened for eligibility and followed up to September 18th, 2022.

      Oocyte donation cycles were utilized because this model is an excellent choice for
      controlling known female characteristics. Previous research concluded that a major predictor
      of ART outcomes is maternal age.

      Eligibility criteria were donors aged older than 18 years or younger than 35 years. After
      providing informed consent, the patients were questioned about their confirmed past
      SARS-Cov-2 infection/vaccination status. Patients were categorized into the vaccinated group
      if they had received two dosages of any SARS-CoV-2 vaccines (BNT162b2 mRNA Pfizer-Biontech,
      mRNA-1273 Moderna or inactivated SARS-CoV-2 vaccine Sinovac) with a break of at least three
      weeks between each dose. First and second vaccine dates were requested of vaccinated
      patients. Vaccine administration details, such as vaccine type, dose, date, manufacturer, and
      lot number, were collected from immunization records.

      For recovering patients, the date of a negative nasopharyngeal COVID polymerase chain
      reaction (PCR) test was registered. None of the recovering patients were vaccinated with any
      SARS-CoV-2 vaccine. Both clinics strictly required a negative PCR test for SARS-CoV-2 RNA
      detection 5 days before oocyte retrieval, except for those patients who were less than 3
      months following recovery from SARS-Cov-2 infection. Patients in the control group were
      selected from medical records prior to March 2020 to ensure they did not have the infection
      and were not vaccinated.

      Data including the patient age, body mass index (BMI), antral follicle count (AFC), anti
      mullerian hormone (AMH), days of stimulation, average dose of gonadotropins, the number of
      retrieved oocytes, mature oocytes, fertilized oocytes and top quality embryos obtained were
      recorded. Other parameters were calculated such as the ratio between the number of retrieved
      oocytes and the number of mature follicles in order to assess the adequacy of response of the
      follicle to the LH/hCG trigger; the fertilization rate (FR), which was defined as the
      proportion of inseminated oocytes with 2PN at the time of the fertilization check on Day 1
      and finally the blastocyst development rate, defined as the proportion of 2PN zygotes which
      are at the blastocyst stage at Day 5.

      All analyses were performed using SPSS 23.0 (SPSS Inc., Chicago, IL, USA). Normally,
      distributed data were compared across study groups by univariate ANOVA. All P-values were
      tested as two-tailed and considered significant at <0.05.
    

Intervention name(s): Sars Cov 2 infection; Sars Cov 2 vaccination
Intervention type(s): Biological; Biological
Intervention description(s): Donors recovered from Sars Cov 2 Infection; Egg Donors vaccinated
Observational model: Cohort
Time perspective: Retrospective
Sampling method: Non-Probability Sample
Study population: 
        Patients were categorized into the vaccinated group if they had received two dosages of any
        SARS-CoV-2 vaccines with a break of at least three weeks between each dose. First and
        second vaccine dates were requested from vaccinated patients. Vaccine administration
        details, such as vaccine type, dose, date, manufacturer, and lot number, were collected
        from immunization records.

        For recovering patients, the date of an adverse nasopharyngeal COVID polymerase chain
        reaction (PCR) test was registered. None of the recovering patients were vaccinated with
        any SARS-CoV-2 vaccine. Both clinics strictly required a negative PCR test for SARS-CoV-2
        RNA detection 5 days before oocyte retrieval, except for those patients who were less than
        3 months following recovery from SARS-Cov-2 infection. Patients in the control group were
        selected from medical records before March 2020 to ensure they did not have an infection
        and were not vaccinated.
      
Keywords: COVID-19; SARS-CoV-2; embryos;; endometrium;; female reproductive system; in vitro fertilization;; menstrual cycle;; oocytes;; ovarian reserve; blastocyst