Prior COVID-19 infection increases degenerated oocytes but does not affect IVF outcomes: A Prospective Cohort Study

Objective: To investigate whether prior COVID-19 infection and time interval after infection affect the in vitro fertilization (IVF) outcomes. Design: A prospective observational cohort. Setting: Reproductive center in China. Population: Participants recovered from COVID-19 and healthy controls. Methods: : All participants received normal IVF treatment. The oocyte and embryo quality as well as pregnancy outcome data were collected and analyzed. Main outcome measure: Oocytes and embryo quality, clinical pregnancy outcomes. Results: : The oocyte and embryo quality were comparable between the two groups, including the number of oocytes, 2PN zygotes, fertilization rate, cleavage embryos, day 3 good-quality embryos, blastocyst formation rate, and good-quality blastocysts. Nevertheless, the study group exhibited more degenerated oocytes (0.15±0.40 vs. 0.10±0.33, P=0.035). Further regression analysis indicated that prior COVID-19 infection is positively related to the number of degenerated oocytes (Adjusted β: 0.06, 95% confidential interval (CI): 0 -0.10, P=0.032). No significant differences were observed in clinical pregnancy rate, implantation rate, early miscarriage rate, ectopic pregnancy rate, and ongoing pregnancy rate. Similarly, we observed no difference in oocyte and embryo quality as well as pregnancy outcomes across various post-infection time intervals. Conclusions: : Preceding COVID-19 could increase the number of degenerated oocytes. However, it does not affect subsequent pregnancy outcomes. Additionally, post-infection time interval plays no significant role in IVF outcomes.