Does mRNA SARS‐CoV‐2 vaccine in the follicular fluid impact follicle and oocyte performance in IVF treatments?

Abstract

Problem:The COVID-19 pandemic has many clinical manifestations. Rapid vaccine development raised concerns and speculations about future fertility outcomes and vaccine safety. We evaluated the effect of Pfizer-BioNTech mRNA SARS-CoV-2 vaccine on IVF treatment, oocyte and embryo quality, and pregnancy outcomes. Method of study:This prospective, observational cohort study was conducted in a referral IVF Unit, 3/2021-5/2021. We aimed to recruit all women undergoing IVF/ICSI cycles from 3/1-4/30/2021, 2-8 weeks after the second vaccination, and to analyze 50-60 samples in the 2-month period. Patients were categorized according to serum antibody levels: positive for spike (S), positive for nucleotide (N), or negative for both.On the day of ovum pick-up, follicular fluid and blood samples were analyzed for antinucleotide (anti-N) antibodies, and anti-spike (anti-S) antibodies, hormonal profile, Creactive protein (CRP) and other metabolic parameters.Results: Of 59 women enrolled, 37 reported being vaccinated and 22 were not. We found 97% correlation between anti-S and anti-N in the blood and the follicular fluid.Follicular fluid was analyzed based on antibody categorization. All IVF treatment parameters in the follicular fluids and serum were comparable, except CRP was significantly elevated among patients with anti-N antibodies (2.

Impact of inactivated SARS-CoV-2 vaccination on embryo ploidy: a retrospective cohort study of 133 PGT-A cycles in China

“…Administration of SARS-CoV-2 vaccine could induce high titers of antigen-specific neutralizing antibodies for CD8 + and Th1 type CD4 + T cells [30]. In addition to serum level changes, anti-SARS-CoV-2 IgG was also detected in the follicular fluid (FF) after vaccination [14,16], suggesting the local involvement of ovary in immune response. More recently, Castiglione Morelli et al [31] found that vaccinated women had higher FF concentrations of Ala and Pro, while levels of lipids, trimethylamine N-oxide and tumor necrosis factor α were lower compared with non-vaccinated control.…”

“…Several studies to date have also assessed the IVF pregnancy outcomes following COVID-19 vaccination, with no significant differences observed in biochemical, clinical or ongoing pregnancy rates [15][16][17][34][35][36]. By analyzing euploid blastocyst transfer cycles, our cohort offers a unique opportunity to investigate independently the possible detrimental effect of vaccine-induced autoimmunity on embryo implantation and pregnancy establishment.…”

“…Indeed, a recent study by Herrero et al [41] suggested that the number of retrieved oocytes and mature oocytes decreased significantly with higher titers of SARS-CoV-2 IgG antibodies in recovered COVID-19 patients. While further studies focusing on patients receiving mRNA vaccines denied this relationship [14,16], it remains for validation whether the conclusion applies to inactivated vaccines as well. In addition, the history of SARS-CoV-2 infection was determined by patient self-report rather than seropositivity measurement.…”

“…Several studies to date have found no association between mRNA COVID-19 vaccine and sperm parameters [9][10][11][12], follicular function [13][14][15][16][17] as well as embryo development [14,15]. With a specific focus on in vitro fertilization (IVF) cycles using preimplantation genetic testing for aneuploidy (PGT-A), one study further demonstrated similar euploidy rate after mRNA COVID-19 vaccination on adjusted analysis [17].…”

The impact of COVID-19 vaccines on fertility-A systematic review and meta-analysis

“…[12] , [21] , [22] , [23] , [24] , [25] , [26] , [27] , [28] , [29] , [30] , [31] , [32] , [33] , [34] , [35] , [36] , [37] , [38] , [39] , [40] , [41] , [42] , [43] , [44] , [45] , [46] , [47] .…”