Abstract
PURPOSE: This investigation aimed to explore the impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection during controlled ovarian stimulation (COS) on the pregnancy and obstetric outcomes in frozen-thawed embryo transfer (FET) cycles. This area has not been thoroughly examined in previous research. METHODS: This retrospective cohort study analyzed 126 couples with confirmed SARS-CoV-2 infection during COS and evaluated FET outcomes using embryos generated during virologically active exposure windows. Controls were noninfected women during COS, matched by age, number, and day of embryo transfer in the same time. Demographic and cycle characteristics and pregnancy and obstetric outcomes were examined for this retrospective cohort analysis. RESULTS: This cohort study comprised 300 infertile couples, stratified into SARS-CoV-2-exposed (n = 126) and unexposed (n = 174) groups based on infection status during COS. The clinical pregnancy rates were 58.8% and 58.6%, respectively (P = 0.958). Other pregnancy features, including biochemical pregnancy, early miscarriage, ongoing pregnancy, and cumulative clinical pregnancy, were also comparable between the two groups. No significant intergroup differences were observed in obstetric outcomes, such as gestational age, cesarean section rates, and preterm birth rates. CONCLUSIONS: In FET cycles of patients with embryos generated from SARS-CoV-2 infection, no significant difference in pregnancy and obstetric outcomes was observed. These data substantiate the reproductive safety of FET following SARS-CoV-2 exposure during COS. Nevertheless, more studies are needed for longitudinal investigations to elucidate the transgenerational effects of SARS-CoV-2 on somatic maturation and neurodevelopmental trajectories in offspring.