Abstract
The global outbreak of the coronavirus disease 2019 (COVID-19) led to the suspension of most treatments with assisted reproductive technique (ART). However, with the recent successful control of the pandemic in China, there is an urgent public need to resume full reproductive care. To determine whether the COVID-19 pandemic had any adverse effects on female fertility and the pregnancy outcomes of women undergoing ART, a systematic review and meta-analysis was conducted using the electronic Chinese and English databases. Dichotomous outcomes were summarized as prevalence, and odds ratios (ORs) and continuous outcomes as standardized mean difference (SMD) with 95% confidence interval (CI). The risk of bias and subgroup analyses were assessed using Stata/SE 15.1 and R 4.1.2. The results showed that compared with women treated by ART in the pre-COVID-19 time frame, women undergoing ART after the COVID-19 pandemic exhibited no significant difference in the clinical pregnancy rate (OR 1.07, 95% CI 0.97 to 1.19; I2=0.0%), miscarriage rate (OR 0.95, 95% CI 0.79 to 1.14; I2=38.4%), embryo cryopreservation rate (OR 2.90, 95% CI 0.17 to 48.13; I2=85.4%), and oocyte cryopreservation rate (OR 0.30, 95% CI 0.03 to 3.65; I2=81.6%). This review provided additional evidence for gynecologists to guide the management of women undergoing ART treatment during the COVID-19 pandemic timeframe.
摘要
目的
2019年全球新型冠状病毒病肺炎(COVID-19)的爆发导致大多数辅助生殖技术(ART)治疗的暂停。然而, 随着最近中国成功控制了大流行, 公众迫切需要恢复全面的生殖保健。因此, 本文讨论COVID-19大流行是否对女性生育能力和接受ART治疗的妇女的妊娠结局有任何不利影响。
方法
使用中英文电子数据库进行了系统评价和荟萃分析。二分类结局总结为患病率和比值比(OR), 连续结局总结为标准化均数差(SMD), 置信度为95%。使用Stata/SE 15.1和R 4.1.2评估偏倚风险和亚组分析。
结论
结果显示, 与COVID-19前接受ART治疗的妇女相比, COVID-19大流行后接受ART治疗的妇女在临床妊娠率(1.07, 0.97∼1.19; I2=0.0%)、流产率(0.95, 0.79∼1.14; I2=38.4%)、胚胎冷冻保存率(2.90, 0.17∼48.13; I2=85.4%)和卵母细胞冷冻保留率(0.30, 0.03∼3.65; I2=81.6%)等方面没有显著差异。该评价为妇科医生提供了额外的证据, 以指导在COVID-19大流行期间接受ART治疗的妇女的管理。
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Acknowledgments
This study was supported by the Health High-Level Talent Training Project (Innovative Talents), the Health Commission of Zhejiang Province (File [2021] 40), and the 151 Talent Project (Second Level), Zhejiang Province Human Resources and Social Security Department (File [2018] 126), China.
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Weihuan HU performed the study design and data analysis, wrote and edited of the manuscript. Yuhang ZHU performed the data analysis. Yan WU visualized the data. Fangfang WANG contributed to the study design and project administration. Fan QU contributed to the study design, funding acquisition, and supervision. All authors have read and approved the final manuscript, and therefore, have full access to all the data in the study and take responsibility for the integrity and security of the data.
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Weihuan HU, Yuhang ZHU, Yan WU, Fangfang WANG, and Fan QU declare that they have no conflict of interest. This article does not contain any studies with human or animal subjects performed by any of the authors.
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Tables S1 and S2; Method S1; Fig. S1
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Hu, W., Zhu, Y., Wu, Y. et al. Impact of COVID-19 pandemic on the pregnancy outcomes of women undergoing assisted reproductive techniques (ARTs): a systematic review and meta-analysis. J. Zhejiang Univ. Sci. B 23, 655–665 (2022). https://doi.org/10.1631/jzus.B2200154
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DOI: https://doi.org/10.1631/jzus.B2200154
Key words
- Systematic review
- Coronavirus disease 2019 (COVID-19)
- Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)
- Assisted reproductive technique (ART)
- Pregnancy outcome
- Meta-analysis