key: cord-0918097-ankvpest
authors: Nasab, Susan; Abhari, Sina
title: COVID-19 Vaccine and IVF outcomes; Myths versus facts
date: 2022-04-08
journal: Fertil Steril
DOI: 10.1016/j.fertnstert.2022.04.005
sha: 8efe2bc662c4d53fc71d52d9d9e4746af67c2261
doc_id: 918097
cord_uid: ankvpest

nan

The Covid-19 outbreak had a strong detrimental effect on fertility services and the mindset of couples seeking fertility treatment. On December 11,2020, the Food and Drug Administration (FDA) issued an emergency use authorization (EUA) for the Pfizer-BioNTech COVID-19 (BNT162b2) vaccine, a lipid, nucleoside-modified messenger ribonucleotide acid (mRNA) vaccine encoding the spike glycoprotein of SARS-CoV-2. On August 23,2021, FDA approved a Biologics License Application for use of Pfizer-BioNTech COVID-19 vaccine in persons age >16 years (1). Despite growing body of evidence regarding the safety of the Pfizer-BioNTech COVID-19 vaccine, the vaccination campaign has been accompanied by concerns regarding the possible immune-mediated detrimental effects on female fertility which led to partial public apprehension and vaccination reluctance. Increasing groups of investigators have focused on the potential correlation between mRNA COVID-19 vaccine and in vitro fertilization (IVF) outcomes. Orvieto and colleagues conducted an observational study including couples who underwent ovarian stimulation (OS) for IVF before and 7-85 days after receiving the second dose of the Pfizer-BioNTech COVID-19 vaccine. The investigators did not find any differences in the length of OS, total dose of gonadotropins used, number of oocytes retrieved, oocyte maturity rate, fertilization rate and top-quality embryos before and after receiving the vaccine (2). Bentov et al conducted a cohort study investigating the effect of immune response to COVID-19 infection or vaccination with the Pfizer-BioNTech COVID-19 vaccine on follicular microenvironment and function. Anti-COVID IgG antibodies were detected in measurable amount in the follicular fluid and serum of individuals with prior COVID-19 infection as well as those with history of vaccination, However, there was no evidence of any detrimental effect on follicular function or ovarian response to stimulation including follicular steroidogenesis, oocyte yield and oocyte maturity rate (3). In their retrospective cohort study, Avraham and colleagues aimed to investigate the influence of BNT162b2 vaccination on ovarian response and IVF treatment outcomes. The study included 200 vaccinated and 200 age-matched unvaccinated controls who underwent IVF between January 1, 2021, and April 31, 2021. Mean time interval between vaccination and egg retrieval was 29.4 (14-68) days. The investigators reported similar IVF cycle characteristics including total gonadotropic dose, peak estradiol level, endometrial thickness on trigger day and the number of oocytes retrieved per cycle between the two groups. The investigators did not find a difference in oocyte fertilization rates and mean number of cryopreserved embryos at both cleavage and blastocyst stage. In addition, for those who underwent fresh embryo transfer, clinical pregnancy rates were comparable between vaccinated and unvaccinated participants (4). The authors accurately point to some limitations in the study including its retrospective nature and lack of data about male partners regarding prior vaccination or infection. In addition, although clinical pregnancy rates were similar between the two groups, the study was powered to detect a 11% reduction in pregnancy rate. Although above mentioned limitations should be considered, the investigators provide a timely and valuable contribution to our knowledge regarding anti-COVID vaccination and assisted reproductive technology (ART) outcomes. Considering potential for severe morbidity and mortality among pregnant women affected by the SARS-CoV-2 virus and growing evidence supporting lack of any detrimental effect of mRNA SARS-CoV-2 vaccine on OS and associated pregnancy rates, reproductive endocrinologists should discuss COVID-19 vaccination with all patients and encourage vaccination during evaluation and treatment for infertility (5) .

Use of Pfizer-BioNTech COVID-19 Vaccine in Persons Aged >/=16 Years: Recommendations of the Advisory Committee on Immunization Practices -United States

Does mRNA SARS-CoV-2 vaccine influence patients' performance during IVF-ET cycle?

Ovarian follicular function is not altered by SARS-CoV-2 infection or BNT162b2 mRNA COVID-19 vaccination

COVID-19 Vaccination and Infertility Treatment Outcomes

The American Society for Reproductive Medicine COVID-19 Task Force COVID-19