Abstract
OBJECTIVE: This multicenter retrospective study examines the impact of female COVID-19 infection on assisted reproductive technology (ART) outcomes, including clinical pregnancy rates, miscarriage rates, and live birth rates, and further evaluated potential influencing factors associated with these outcomes. METHODS: Our multicenter retrospective cohort study analyzed 10,140 cycles (2021-2023) from 10 Beijing ART centers, comparing 4,099 cycles from COVID-19-positive women with 6,041 age-matched (1:1.5) COVID-negative controls (pre-pandemic). Outcomes included pregnancy, miscarriage, and live birth rates, analyzed via logistic regression. RESULTS: In our study, maternal COVID-19 infection showed no significant association with ART outcomes, including clinical pregnancy, miscarriage and live birth. However, subtle differences were still observed. Among women with prior COVID-19 infection, compared to those with transfers ≥ 90 days post-infection (16.1%), miscarriage rates were significantly higher in the < 30 days (20.5%, p = 0.055) and 30-60 days (20.4%, p = 0.032) groups, whereas no increase was observed in the 60-90 days group (15.3%, p = 0.912). Additionally, advanced maternal age and elevated FSH levels (> 10 mIU/mL) were associated with diminished clinical pregnancy and live birth rates. What's more, maternal COVID-19 symptoms and medication use did not significantly affect ART treatment outcomes. CONCLUSIONS: Our results suggest that while maternal COVID-19 infection does not clearly affect overall ART outcomes, embryo transfer within 60 days may increase miscarriage risk. This provides useful guidance for timing treatment during COVID-19 and future public health emergencies. IN BRIEF: Our study found that while a history of the female partner's COVID-19 infection does not significantly impact ART outcomes, miscarriage rates are higher when embryo transfer occurs within 60 days post-infection. We recommend waiting at least 60 days after infection to minimize miscarriage risk.