Association Between Time Interval from COVID-19 Vaccination to In Vitro Fertilization and Pregnancy Rate After Fresh Embryo Transfer

Shi, Wenhao; Wang, Min; Xue, Xia; Li, Na; Chen, Lijuan; Shi, Juanzi

doi:10.1001/jamanetworkopen.2022.36609

Cited by 20 publications

(42 citation statements)

References 19 publications

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“…Twelve studies analyzed clinical pregnancy rate, no difference was observed in all the studies (30-34, [36][37][38][39][40][41][42] and also in our study.…”

Section: Clinical Pregnancy Ratementioning

confidence: 45%

Safety of COVID-19 vaccination in women undergoing IVF/ICSI treatment - Clinical study and systematic review

et al. 2023

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BackgroundIt was suggested that vaccination in general might affect reproductive health. Safety of COVID-19 vaccination in women undergoing assisted reproductive techniques (ART) treatment is not well established.MethodsWe performed a retrospective study including 536 women undergoing fresh embryo transfer after IVF/ICSI treatment in a huge IVF center in southern China to investigate the effect of COVID-19 vaccination on oocyte maturation, fertilization rate, blastulation rate, implantation rate, clinical pregnancy rate and miscarriage rate. In addition, we performed a systematic review of existing studies on the safety of COVID-19 vaccination in women undergoing ART treatment.ResultsIn our study, 268 women received inactivated or recombinant COVID-19 vaccination and 268 controls were enrolled based on propensity score matching. We observed a decreased fertilization rate and signs for impaired oocyte maturation in vaccinated women. Besides our study, there were 15 studies analyzing the safety of COVID-19 vaccination in women undergoing ART treatment. For the mRNA vaccines, no adverse signals were reported concerning oocyte maturation, fertilization rate, blastulation rate, implantation rate, clinical pregnancy rate and miscarriage rate. In women being vaccinated with an inactivated vaccine, implantation rate, clinical pregnancy rate and miscarriage rate were not affected, whereas oocyte maturation and fertilization rate were impaired.ConclusionsVaccination against COVID-19 in women undergoing ART treatment seems to be safe especially for women getting mRNA vaccines. The effects on oocyte maturation and fertilization rate of inactivated and recombinant COVID-19 vaccinations might be a safety signal and need further investigation and independent confirmation.

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“…Twelve studies analyzed clinical pregnancy rate, no difference was observed in all the studies (30-34, [36][37][38][39][40][41][42] and also in our study.…”

Section: Clinical Pregnancy Ratementioning

confidence: 45%

Safety of COVID-19 vaccination in women undergoing IVF/ICSI treatment - Clinical study and systematic review

et al. 2023

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“…Author affiliations and article information are listed at the end of this article. Shi et al 4 addressed an important question with a large group of patients, but there are a couple of important limitations to discuss. Although the overall sample size of the study is large, the subgroups who received vaccination 30 days or less (n = 35) and 30 to 60 days (n = 58) before undergoing IVF were relatively small.…”

Section: + Related Articlementioning

confidence: 99%

“…Of importance, the vaccines received by participants in the study by Shi et al 4 were all inactivated-virus vaccines that were available in China where the study was performed. These results should, therefore, be generalized with extreme caution, as they may not be applicable or reproducible in the US, where most of the vaccines administered have been mRNA based (eg, BNT162b2 [Pfizer-BioNTech] and mRNA-1273 [Moderna]).…”

mentioning

confidence: 99%

“…In contrast to other studies, the study by Shi et al 4 included participants in the vaccinated group who received their second vaccine dose while in the middle of ART treatment. Although the authors noted that most patients did not experience adverse effects after the second dose of the vaccine, it is possible that the acute immune reaction could affect early pregnancy implantation and development.…”

mentioning

confidence: 99%

“…Beyond vaccine type and vaccination timing, the study findings may not be generalizable worldwide given the low rates of SARS-CoV-2 infection in China during the study period. Shi et al 4 had to exclude only 33 participants of the nearly 8000 patients who were screened for the study. In contrast, it is estimated that more than 80% of the US population has been infected at least once with SARS-CoV-2.…”

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confidence: 99%

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In Vitro Fertilization Outcomes After Inactivated COVID-19 Vaccine

Shandley

Hipp

2022

JAMA Netw Open

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Over the past 2.5 years, the global COVID-19 pandemic has killed millions of people worldwide, with consequences for every sector of the global economy, most notably, the health care system. Every medical specialty has been affected by the pandemic, including reproductive health care and assisted reproductive technology (ART). In the early, prevaccination days of the pandemic, resource scarcity and lack of knowledge about the implications of SARS-CoV-2 infection for fertility and pregnancy led to clinical guidelines that advised the temporary cessation of ART and diversion of resources toward helping the frontline fight against COVID-19. Today, thanks in large part to the advent of vaccines against SARS-CoV-2, the fatality and severity of COVID-19 have decreased substantially.With the advent of these vaccines, questions arose regarding their implications for reproductive health, resulting in substantial vaccine hesitancy in some populations. Reassuringly, current studies have found that COVID-19 messenger RNA vaccines are not associated with adverse fertility, ART, or early pregnancy outcomes. [1][2][3] In their study, Shi et al 4 reported on the association of inactivated COVID-19 vaccination with ongoing pregnancy rates after in vitro fertilization (IVF) with a fresh embryo transfer. The authors found that, in China, patients in an ART center who were vaccinated 30 days or less or between 30 and 60 days before undergoing IVF had lower rates of ongoing pregnancy (34.3% and 36.2%, respectively) than patients who underwent IVF 91 days or more after COVID-19 vaccination (56.3%). After adjusting for confounders, Shi et al 4 observed that the adjusted risk ratio (aRR) for ongoing pregnancy was lower in those who were vaccinated 30 days or less (aRR, 0.61; 95% CI, 0.33-0.91) or 30 to 60 days (aRR, 0.63; 95% CI, 0.42-0.85) before undergoing IVF compared with unvaccinated participants, whereas there was no difference between those who had been vaccinated more than 60 days before IVF and those who were unvaccinated. Shi et al 4 concluded that patients undergoing IVF with a fresh embryo transfer may need to delay treatment for at least 60 days after being vaccinated. access to reproductive health care affect patients' well-being.

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Maternal and neonatal safety of COVID‐19 vaccination during the peri‐pregnancy period: A prospective study

Hao

Jiang

et al. 2022

Journal of Medical Virology

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Background To investigate the safety of inactivated COVID‐19 vaccine in Chinese pregnant women and their fetuses when inoculated during the peri‐pregnancy period. Methods Eligible pregnant women were prospectively collected and divided into a vaccine group (n = 93) and control group (n = 160) according to whether they had been vaccinated against COVID‐19 within 3 months before their last menstruation period (LMP) and after pregnancy. Demographic data of couples, complications during pregnancy and delivery of pregnant women, and data of newborns at birth were collected. Results Sixty‐six women were vaccinated with a median time of 35.5 (range = 0–91) days before LMP, and 27 women were vaccinated with a median time of 17 (range = 1–72) days after LMP. The incidence of premature rupture of membrane (PROM) in the vaccine group was significantly higher than that in the control group (16.13% vs. 6.88%, p = 0.019). Multivariate logistic regression analysis revealed that maternal peri‐pregnancy COVID‐19 vaccination was not an independent risk factor for PROM (odds ratio: 2.407, 95% confidence interval: 0.932–6.216, p = 0.069). There was no difference in the incidence of other complications during pregnancy and delivery between the two groups. A total of 253 neonates were delivered, including two cases with congenital abnormalities in each group. The incidence of congenital abnormalities between the two groups was similar (2.15% vs. 1.25%, p = 0.626). There was no difference in neonatal length, weight, head circumference, and Apgar score between the two groups (p > 0.05), but the incidence of neonatal jaundice in the vaccine group was significantly higher than that in the control group (20.43% vs. 7.5%, p = 0.002). Multivariate logistic regression analysis revealed that maternal peri‐pregnancy vaccination, postpartum blood loss, cesarean section, 1‐min Apgar score, and paternal smoking were independent risk factors for neonatal jaundice. Conclusions It is safe for pregnant women and their fetuses to be inoculated the inactivated COVID‐19 vaccine during the peri‐pregnancy period, but attention should be paid to neonatal jaundice.

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Association Between Time Interval from COVID-19 Vaccination to In Vitro Fertilization and Pregnancy Rate After Fresh Embryo Transfer

Cited by 20 publications

References 19 publications

Safety of COVID-19 vaccination in women undergoing IVF/ICSI treatment - Clinical study and systematic review

Safety of COVID-19 vaccination in women undergoing IVF/ICSI treatment - Clinical study and systematic review

In Vitro Fertilization Outcomes After Inactivated COVID-19 Vaccine

Maternal and neonatal safety of COVID‐19 vaccination during the peri‐pregnancy period: A prospective study

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