STUDY QUESTION
How did coronavirus disease 2019 (COVID-19) impact on medically assisted reproduction (MAR) services in Europe during the COVID-19 pandemic (March to May 2020)?
SUMMARY ANSWER
MAR services, and hence treatments for infertile couples, were stopped in most European countries for a mean of 7 weeks.
WHAT IS KNOWN ALREADY
With the outbreak of COVID-19 in Europe, non-urgent medical care was reduced by local authorities to preserve health resources and maintain social distancing. Furthermore, ESHRE and other societies recommended to postpone ART pregnancies as of 14 March 2020.
STUDY DESIGN, SIZE, DURATION
A structured questionnaire was distributed in April among the ESHRE Committee of National Representatives, followed by further information collection through email.
PARTICIPANTS/MATERIALS, SETTING, METHODS
The information was collected through the questionnaire and afterwards summarised and aligned with data from the European Centre for Disease Control on the number of COVID-19 cases per country.
MAIN RESULTS AND THE ROLE OF CHANCE
By aligning the data for each country with respective epidemiological data, we show a large variation in the time and the phase in the epidemic in the curve when MAR/ART treatments were suspended and restarted. Similarly, the duration of interruption varied. Fertility preservation treatments and patient supportive care for patients remained available during the pandemic.
LARGE SCALE DATA
N/A
LIMITATIONS, REASONS FOR CAUTION
Data collection was prone to misinterpretation of the questions and replies, and required further follow-up to check the accuracy. Some representatives reported that they, themselves, were not always aware of the situation throughout the country or reported difficulties with providing single generalised replies, for instance when there were regional differences within their country.
WIDER IMPLICATIONS OF THE FINDINGS
The current article provides a basis for further research of the different strategies developed in response to the COVID-19 crisis. Such conclusions will be invaluable for health authorities and healthcare professionals with respect to future similar situations.
STUDY FUNDING/COMPETING INTEREST(S)
There was no funding for the study, apart from technical support from ESHRE. The authors had no COI to disclose.
Controversies surrounding the effect of ES on pregnancy outcome in women with RIF are mostly due to the poorly defined target population. We evaluated the effect of ES on clinical outcomes in women with strict criteria of RIF before IVF/ICSI. We also examined the effect of ES on the expression of markers of endometrial receptivity. Women with failed implantation after transfer of seven or more top quality day 3 embryos or three blastocysts underwent the scratch procedure on exact days of the cycle prior to IVF/ ICSI. Results were compared to no scratch control group. Using histopathology, immunohistochemistry, and scanning electron microscopy, we also examined the effect of injury on the endometrial receptivity in a separate series of observations with double ES. Cumulative pregnancy rate was significantly higher in the study group as compared to control (54.8% vs. 29.0%; p < .05). The effect of ES on the clinical outcome was seen during fresh ET, but not on the next FET cycles. ES improves impaired endometrial receptivity by partially normalizing the expression of estrogen and progesterone receptors (ERs, PRs) and pinopodes. We concluded that in a well-defined subpopulation of infertile women with RIF, ES significantly enhances pregnancy rates. ES has a specific impact on endometrial receptivity normalizing the expression of some markers.
In this report, we present a case of unexplained total triploidy of donor eggs fertilized by ICSI from four different male partners of different couples. Woman who served as a donor was 27 year old, had her own healthy child, and previously twice served as a donor with normal fertilizations and healthy baby born.
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